RISK FACTORS AND PREVENTION OF ENDOMETRIAL CANCER

Endometrial cancer is the most common gynecological malignancy in many high-income settings, and its global burden is rising. A central reason is that the strongest population-level drivers of risk—excess adiposity and metabolic dysfunction—have become more prevalent in many regions, reshaping both incidence patterns and the age distribution of disease. Current evidence supports a conceptual model in which prolonged exposure of the endometrium to mitogenic signals, especially “unopposed” estrogen and related endocrine-metabolic pathways, increases the likelihood of precursor lesions and malignant transformation. This model explains the contribution of obesity, insulin resistance, type 2 diabetes, anovulation and polycystic ovary syndrome, exogenous estrogen without adequate progestin protection, and certain medications such as tamoxifen. In parallel, a smaller but clinically crucial proportion of cases arises from inherited cancer predisposition syndromes, most prominently Lynch syndrome, which demands tailored preventive strategies that differ from those used in the general population.

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