Endometrial cancer is the most common gynecological cancer in developed countries and is the 5th most frequent cancer affecting woman. The estimated frequency is 19.1 / 100,000 cases in the USA and Canada and 15.6 / 100,000 in Europe.
It is usually associated with menopause, although up to 14% of cases are diagnosed in premenopausal women and up to 5% of cases in patients under the age of 40 years. It is usually diagnosed in early stages and with the tumor usually confined to the uterine cavity, which generally gives it a good prognosis
The main risk factor is continued unopposed exposure to elevated estrogen levels. Among the different causes related to endometrial cancer are:
1- Obesity: is present in 40-50% of endometrial carcinomas in developed countries. Obese women are 2-4 times more likely to develop endometrial cancer than non-obese women.
2- Unopposed estrogen therapy (UET). The use of UET greatly increases the formation of endometrial hyperplasia and endometrial carcinoma. This risk increases in relation to the dose and duration of the exposure. The administration of progesterone during HRT eliminates the risk of both endometrial hyperplasia and carcinoma.
3- Tamoxifen: It is a selective estrogen receptor modulator (SERM) that is commonly used as an adjuvant hormone treatment in women with breast cancer. The use of tamoxifen is associated with a 2-5-fold increased risk of developing endometrial pathology, including polyps and endometrial cancer.
4- Hereditary: Endometrial carcinoma may appear in the context of a Lynch II syndrome or hereditary colorectal cancer not associated with polyposis (HNPCC). It is an autonomic dominant disorder with incomplete penetrance. Women with HNPCC have a risk of about 50% developing endometrial cancer.