Epidemiology and risk factors

Endometrial cancer (EC) is the seventh most common female cancer in the world and the fourth in developed countries, where the age-standardised incidence rates are more than twice that of developing countries. About 290,000 new cases of EC are diagnosed every year worldwide, 90% in women older than 50. About 74,000 women die every year for EC. Because of its favourable prognosis, it is considered a cause of morbidity rather than mortality. Increasing incidence trends observed in last decades are related to characteristics linked to Westernisation of lifestyles. The etiopathogenesis of EC has been linked, at least in part, to high and prolonged estrogen levels. Obesity is considered responsible for 40% of incidence. Other well recognised risk factors are: early age at menarche, nulliparity, late age at menopause, unopposed estrogen hormone replacement therapy use, never oral contraceptives use, history of diabetes and metabolic syndrome. Other risk factors have a more limited and/or controversial role, and do not help to identify a high risk population.