Polycystic ovary syndrome (PCOS), a common hormonal disorder affecting up to five million women in the United States, may increase the risk of uterine cancer. The condition occurs when small, fluid-filled sacs—called cysts—form on the ovaries. While many women with PCOS have no symptoms, the syndrome can cause hormonal imbalances that contribute to other health problems.
“Simple ovarian cysts alone are not precancerous and don’t increase ovarian cancer risk,” says Peter Frederick, MD, FACOG, Clinical Chief of Gynecology at Roswell Park Comprehensive Cancer Center. “However, PCOS is associated with infertility, obesity, chronic lack of ovulation, hormonal imbalances, and low-grade inflammation. These factors can slightly raise ovarian cancer risk, but studies are inconsistent. What is clear is that PCOS increases the risk of uterine cancer.”
Uterine cancer is the fourth most common cancer in U.S. women, with endometrial cancer—affecting the lining of the uterus—being the most prevalent type. The lifetime risk of uterine cancer for women with PCOS is around 8–9%, compared with 3% for the general population.
PCOS can also disrupt insulin regulation, increasing the risk of type 2 diabetes. The condition often runs in families, highlighting the role of genetics in its development.
Treatment Can Reduce Cancer Risk
Oral contraceptives are a common treatment for PCOS, helping to regulate menstrual cycles and hormone levels. “Balancing estrogen and progesterone with contraceptives not only manages PCOS symptoms but also lowers the risk of ovarian and endometrial cancers,” Dr. Frederick explains.
Lifestyle interventions, including healthy diets and regular exercise, are also critical. Roswell Park supports patients with wearable devices and smartphone apps to track activity and monitor blood glucose levels, contributing to studies on the link between physical activity and cancer outcomes.
Recognizing Symptoms and Early Detection
Common symptoms of uterine cancer include irregular or heavy menstrual bleeding and postmenopausal bleeding. “Any abnormal bleeding should be evaluated promptly. Early detection through endometrial biopsy significantly improves prognosis,” Dr. Frederick says.
For women with a strong family history of cancer, genetic counseling and testing can help identify inherited risks and guide prevention strategies.
Comprehensive Treatment Options
The standard treatment for uterine cancer is a hysterectomy, sometimes including removal of the ovaries and fallopian tubes. For younger patients wishing to preserve fertility, Dr. Frederick notes that fertility-sparing approaches may be possible in consultation with specialists.
Progesterone therapy—via oral tablets, injections, or intrauterine devices—may be used for low-grade uterine cancers or patients who cannot undergo surgery. Advanced or recurrent cases may be treated with immunotherapy or other targeted therapies, offering improved survival and quality of life.
“Each treatment plan is individualized. We focus on addressing cancer while considering the patient’s overall health, genetics, and reproductive goals,” Dr. Frederick adds.
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