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Key factors influencing the microbiome and endometrial cancer risk

A recent study examined the role of key factors in altering the reproductive tract microbiome and endometrial cancer risk.

Endometrial cancer, a type of cancer that affects the lining of the uterus known as the endometrium, is the sixth most common cancer worldwide amongst women. The known risk factors for endometrial cancer include estrogen levels, obesity, diabetes, and postmenopausal status. Postmenopausal women with high body mass index (BMI) are considered to be at an increased risk of developing endometrial cancer because of higher levels of estrogen in the blood. According to several studies, alterations in diet, lifestyle, and vaginal microbiome led to a rise in endometrial cancer incidence rates in western countries.

Several studies suggest that changes in the microbiome contribute to causing and developing cancer. In 2017, researchers from Mayo Clinic reported differences in uterine and vaginal microbiome between the patients with endometrial cancer and those without. The researchers found higher representation of the microbiome signature associated with endometrial cancer in patients with endometrial cancer. This discovery led to the development of a vaginal swab screening tool for endometrial cancer.

A recent study, published in Scientific Reports, investigated how risk factors for endometrial cancer alter the reproductive tract microbiome and endometrial cancer risk. The study recruited around 150 women who were undergoing hysterectomy for either endometrial cancer or a benign uterine disease at the Mayo Clinic in Rochester, Minnesota. Upon enrollment, the participants completed a questionnaire in which they provided information on their sexual and reproductive health history. The researchers first studied the microbiome of participants without endometrial cancer to help understand the impact of the cancer risk factors on microbiome composition. They developed a qPCR test to differentiate the participants with endometrial cancer from those without based only on the microbiome results.

The findings of the study confirmed that the previously known risk factors, postmenopausal status, and obesity, are associated with endometrial cancer and identified vaginal pH as an additional risk factor in association with endometrial cancer. The study reported the above-mentioned risk factors modified the composition of the reproductive tract microbiome by increasing its microbial diversity. This increase in diversity in the microbiome, associated with the risk factors, was found to be detrimental to the patient’s reproductive health.

The researchers identified post menopause as a key factor linked to the presence of the microbiome signature associated with endometrial cancer. They suggest looking into translational approaches of this finding that may address current health disparities in endometrial cancer. Future research studies will involve further investigating the role of the microbiome in endometrial cancer. According to researchers, the findings of this study provide them the knowledge and application to further develop their vaginal swab screening tool for endometrial cancer.

Written by Ranjani Sabarinathan, MSc


Walsh DM, Hokenstad AN, Chen J, et al. (2019). Postmenopause as a key factor in the composition of the Endometrial Cancer Microbiome (ECbiome). Scientific Reports. doi: 10.1038/s41598-019-55720-8

Mayo Clinic researchers look at post menopause as key factor in endometrial cancer. (2019, December 16). Retrieved from

Endometrial cancer statistics:

The Human Microbiome:

Image by skeeze from Pixabay



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