Women have a one-in-three chance of developing cancer in their lifetimes. Menopause does not increase cancer risk, but the likelihood of many cancers increases with age. In general, there are specific modifiable and nonmodifiable risk factors for most types of cancer.  

Nonmodifiable risks include age, race, and a family history. Modifiable risks include obesity, alcohol consumption, exercise, nutrition, socioeconomic status, and smoking. Increased awareness of cancer symptoms and routine screening have allowed many cancers to be diagnosed at early stages when they are the most curable.  

Breast Cancer 

Breast cancer is a common fear for midlife women, perhaps because it is the most common cancer diagnosed in that age group. Fortunately, the percentage of women dying from breast cancer has steadily decreased in recent decades. Smaller, less-advanced cancers can now be detected earlier with mammography and other screening methods, and treatment methods have improved. Because many breast cancer risk factors cannot be changed, early detection is the best strategy. The value of the regular breast self-examination has become controversial, but women are still advised to report any changes in their breasts to their healthcare professional. Mammography is recommended for breast assessment and screening; however, recommendations for when and how often to get a mammogram vary, so check with your healthcare professional.

Endometrial (Uterine) Cancer

Cancer can develop in the lining of the uterus (the endometrium). It’s the fourth most common cancer in US women, although it’s uncommon in women aged younger than 45 years. Previous pregnancies and oral contraceptive use provide some protection. Most often, a diagnosis results from evaluation of a woman’s report of abnormal uterine bleeding. This is commonly done with an endometrial biopsy. Other options that may be used include transvaginal ultrasound, sonohysterography (an ultrasound view of the uterus with the uterus filled with salt water), or hysteroscopy (viewing the inside of the uterus with a fiber-optic instrument) to evaluate the uterine lining and to look for endometrial cancer or other causes of the abnormal bleeding. The standard therapy for diagnosed endometrial cancer is surgery, which includes a hysterectomy. 

Cervical Cancer 

Worldwide, cervical cancer is currently the fourth most common cancer in women. However, prevention efforts with vaccinations are expected to dramatically decrease both the incidence and mortality rates. Menopause has not been linked to increased risk of cancer of the cervix (the opening to the uterus found inside the vagina). Virtually all cervical cancers are related to sexually transmitted infections (STIs)—specifically certain types of human papillomavirus (HPV). Women who began having sexual intercourse at an early age or who have had many sexual partners are at increased risk of cervical cancer. Symptoms of cervical cancer include abnormal bleeding and spotting, as well as abnormal vaginal discharge. These symptoms may occur at an early or late stage, although early cervical cancer often does not cause noticeable symptoms. Fortunately, the death rate from cancer of the cervix has dropped sharply in the United States and Canada, but it remains a serious concern. If diagnosed early, cervical cancer is curable, so, women need to continue with appropriate screening. 

Ovarian Cancer 

Although ovarian cancer is not particularly common in women in the United States and Canada, it’s the fifth most common cause of cancer deaths in women. The main reason for this disparity is that this type of cancer is often not caught until it’s more advanced, which is when it tends to cause noticeable symptoms. Less than 25% of cases are diagnosed in the early stages. Ovarian cancer risk is not affected by menopause, but like most other cancers, risk does increase with age. Women with a family history of breast or ovarian cancer are at the highest risk for the disease. An association has been found between Lynch syndrome (a hereditary colorectal cancer syndrome) and ovarian cancer. Conversely, a history of pregnancy, breastfeeding, past use of birth control pills, or a bilateral tubal ligation (both fallopian tubes surgically closed or tied to prevent pregnancy) has been consistently linked to a lower ovarian cancer risk. 

Lung Cancer 

Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined. Most lung cancers in North America can be attributed to tobacco smoking, and women may be more susceptible to the carcinogenic effects of tobacco than men. However, as many as 15% of lung cancers develop in nonsmoking women. Other risk factors include genetics, previous radiation therapy to the chest, and exposure to environmental factors such as secondhand smoke, pollution, asbestos, and radon. Of all the lifestyle-related risk factors that can be changed, smoking cessation has the greatest effect on reducing lung cancer deaths. Cessation has been shown to decrease the risk of lung cancer by up to 90%. 

Colorectal Cancer 

Colorectal cancer is the third most commonly diagnosed cancer in the United States and the third leading cause of cancer death in US women. It includes cancers of the colon (the lower part of the intestine) and the rectum (the part of the intestine that leads from the colon to the anus). More than 4% of Americans are expected to develop the disease in their lifetimes, and the median age at diagnosis is 67. Risk factors for colorectal cancer include family history and inherited syndromes that greatly increase the number of polyps (which can develop into cancer) in the colon and rectum. Other risk factors that can’t be changed include ethnicity (risk is higher in Black and Hispanic populations), age (risk increases greatly after age 50), and a personal history of inflammatory bowel disease. Other risk factors are modifiable. Women can lower their risk of colorectal cancer by stopping smoking, exercising regularly, and eating a healthy diet (particularly one with lower fat intake and limited intake of red and processed meats). The occurrence of colorectal cancer has declined significantly in recent decades. The most important reason for the decline is thought to be because of the removal of polyps at the first screening colonoscopy.  

Skin Cancer 

Certain types of skin cancer become more prevalent in women at midlife and beyond. Basal cell carcinoma and squamous cell carcinoma, by far the most common types, have high cure rates with treatment. Melanoma, although much less common, is significantly deadlier. Ultraviolet light exposure is an important risk factor for all of the most common skin cancers. In particular, a history of blistering sunburns and the use of tanning beds greatly increased risk. Other risk factors include having fair skin, an inability to tan, a family history, and a significant number of moles. Sun protection is essential to both preventing skin cancer and caring for aging skin. Women with a personal or family history of skin cancer should also have an annual full-body skin examination. 

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