A 57-year-old nulliparous woman with high BMI is at increased risk for which type of cancer?

• A. Ovarian cancer
• B. Cervical cancer
• C. Endometrial cancer
• D. Breast cancer

Answer: (C)

Nulliparity and a high body mass index (BMI) are significant risk factors for endometrial cancer. Women who have never given birth (nulliparous) have a longer cumulative exposure to estrogen, as pregnancy typically reduces the number of menstrual cycles and thus the duration of estrogen stimulation on the endometrial lining. High BMI is associated with increased estrogen levels due to the aromatization of androgens in adipose tissue. Elevated estrogen levels unopposed by progesterone can lead to excessive growth of the endometrium, increasing the risk of developing endometrial cancer.

While other cancers may also have a relationship with BMI and reproductive history, the specific combination of nulliparity and high BMI significantly heightens the risk for endometrial cancer more than the other cancers listed.