Obesity Endometrial Cancer — SCE Medical Oncology MCQ
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Correct answer: C — Greater peripheral aromatisation and lower SHBG increase bioavailable oestrogen, promoting endometrial proliferation
Explanation lettering: D = shown as A · C = shown as B · A = shown as C · E = shown as D · B = shown as E
A is correct. In postmenopausal adipose tissue, aromatase converts adrenal androgens to oestrogens; obesity also lowers sex-hormone-binding globulin through hyperinsulinaemia, increasing bioavailable oestrogen. Without cyclical progesterone opposition this promotes endometrial proliferation, while insulin, IGF and inflammatory pathways add risk. B reverses the oestrogen effect. C assigns the wrong adipokine and ovarian mechanism. D reverses insulin signalling and misstates the target tissue. E invents a progesterone-to-dihydrotestosterone pathway. This association is strongest for endometrioid, hormone-related disease but is not the sole causal pathway.
Reference: NHS causes of womb cancer: https://www.nhs.uk/conditions/womb-cancer/causes/