Which factor can indicate a higher risk of endometrial carcinoma?

Unopposed estrogen therapy is associated with an increased risk of endometrial carcinoma due to its effect on the endometrial lining. Estrogen stimulates the growth of the endometrium, and when it is unopposed by progesterone, it can lead to hyperplasia of the endometrial tissue. This hyperplasia may increase the likelihood of cells undergoing malignant transformation, resulting in endometrial carcinoma.

In women with intact uteri who are receiving estrogen replacement therapy, it is crucial to include progesterone to counteract the proliferative effects of estrogen. Without this balance, the risk of endometrial cancer significantly rises over time. Therefore, unopposed estrogen therapy is a key factor in identifying individuals at higher risk for developing endometrial carcinoma. The other choices provided, such as regular exercise, a diet rich in vegetables, and early menopause, typically do not increase the risk and are often associated with improved overall health and reduced cancer risk.