Early Onset Endometrial Cancer Signals Lynch Syndrome

Women who were diagnosed with endometrial cancer under the age of 50 had tumors with signs of Lynch syndrome in a significant number of cases.  Lynch syndrome or hereditary non-polyposis colon cancer (HNPCC) greatly increases the lifetime risk of both colorectal and endometrial cancer.

Researchers in Australia studied tumors from 146 women who were diagnosed with endometrial cancer before the age of 51.  They stained the tumor sections for proteins expression by mismatch repair genes, a genetic mutation that leads to Lynch syndrome cancers.  They also tested tumor DNA for other changes that can identify or exclude Lynch syndrome, and reviewed family medical history where it was available.

They found 26 tumors that were presumed to be due to Lynch syndrome or 18 percent of all the early endometrial cancers.  The tumors were more likely to be poorly differentiated, stage II, have rapidly dividing cells, and invade the wall of the uterus more deeply.

Patients with the presumptive Lynch syndrome tumors were also more likely to have a family history of cancer, Lynch associated cancer in a first-degree relative, or family colon cancer histories that met the Amsterdam criteria for Lynch syndrome.

The research team concluded that endometrial cancers diagnosed in women fifty or younger should be routinely tested by immunohistochemistry for proteins associated with Lynch syndrome.

Michael Walsh and his colleagues wrote,

Presumptive Lynch syndrome was identified in 18% of early-onset endometrial cancer. A risk of this magnitude would argue for routine immunohistochemical testing of tumors in patients diagnosed with EC at or before the age of 50 years.

SOURCE: Walsh et al., Clinical Cancer Research, March 15, 2008.


  1. Anna says


    I was so happy to find this article. Yesterday my grandmother told me she had endometrial cancer at the age of 31. Her doctor was shocked she had it at that age. They found the cancer when she had a hysterectomy due to her uterus being tilted, which was causing back pain. None of her sisters or anyone in our family history has had it. There is no family history of colon cancer either. Should I be concerned? Should I tell my doctor as well?
    I was also taking birth control pills for 6-7 years. I’m not anymore since I have an IUD. Should that period of taking the pill have lowered my risk? Thanks for any advice you can give!

  2. Lynn says

    Hi Kate,

    You’re right! I did answer my own question and I trust that I will be in good hands. Since my last message to you I did a little research on the da Vinci robotic system & It sounds pretty amazing.

    Anyway, thanks again for your advice and input!


  3. Kate Murphy says


    I think you have answered your own question. You say that your surgeon is a cancer specialist and is well-respected.

    If she has done robotic surgery sufficient numbers of time — and I don’t know how many that would be — then you can trust her to give you good advice about robotic surgery.

    Your gynecologist may not realize how effective these surgeries can be or doesn’t do them.

    It is very important that cancer surgery be done by cancer specialists. Although you don’t have cancer yet, a gynecological oncologist (specialist in women’s cancers) will make a difference.

    That you have already had a colectomy makes the surgery a bit different, so you do need that specialist.

    I haven’t heard bad stories about robotic surgery, especially when the surgeon doing it is trained in the techniques and experienced.

  4. Lynn says


    Thank you for responding, I am so grateful for your input.

    I have decided to go through with the procedure and I will have my ovaries removed as well. The surgery is scheduled in June. My surgeon wants to do the surgery with a robotic device (can’t remember the technical name for the robotic system). My gynecologist is against it. Are you familiar with robotic surgeries? My surgeon is a female cancer specialist & her partner did my colectomy, so I do trust them and they are well respected in Las Vegas. However my gynecologist scared me with some of the stories of woman that have gone through it. Anyway, if you have any information I would greatly appreciate your thought on robotic surgery.

    Thank you!

  5. Kate Murphy says


    As you know,Lynch syndrome puts you at high risk for endometrial cancer. Women with Lynch syndrome have about a 60 percent risk of getting endometrial cancer in their lifetime, often before age 50.

    If you have a hysterectomy, it is really important to remove ovaries at the same time since there is also a significant risk for ovarian cancer, and ovarian cancer is more difficult to diagnosis early.

    Usually the recommendation for hysterectomy is for after childbearing is over. If your family is complete, then having the surgery makes a lot of sense, particularly because your aunt died of the disease so young.

    Waiting until you have endometrial cancer isn’t the best plan. Diagnosed early, it is can be cured with surgery, but it is harder to diagnose early in women before menopause because vaginal bleeding that might signal the disease can be missed as a menstrual period.

    When your ovaries are removed, you can have symptoms of menopause — hot flashes and perhaps vaginal dryness. Talk to a good gynecological oncologist about hormone replacement therapy for a year or two to manage them.

    I’m sorry about your mom and your aunt. This is a hard disease for families to cope with.

  6. Lynn says

    In 2008 when I turned 38, I was diagnosed with colon cancer & after genetic testing it was discovered that I have Lynch Syndrome so I had a total colectomy. The doctors wanted to do a hysterectomy at the same time because of my high risk of endometrial cancer, however it was to much for me to handle at the time. So now, 2 yrs later I have decided to go through with the hysterectomy. As far as we know I don’t have endometrial cancer so I’m on the fence about the procedure. Based on this article and your research what is your thought on my situation. Thanks!

    Also, my mother died of colon cancer at age 49 & her twin sister died of endometrial cancer at age 45.

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