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Endometrial Cancer Prevention (PDQ®): Prevention - Health Professional Information [NCI] - Description of Evidence


Incidence and mortality

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Endometrial cancer is the most common invasive gynecologic cancer in U.S. women, with an estimated 52,630 new cases expected to occur in 2014.[1] This disease primarily affects postmenopausal women at an average age of 60 years at diagnosis.[2] In the United States, it is estimated that approximately 8,590 women will die of endometrial cancer in 2014. From 2006 to 2010, incidence rates of endometrial cancer increased by 1.5% per year in women younger than 50 years and increased by 2.6% per year in women aged 50 years and older. During that same time, death rates from endometrial cancer increased by 1.5% per year in women younger than 50 years and remained stable in women aged 50 years and older.[1]

In the mid-1970s, the diagnosis of approximately 15,000 cases of postmenopausal endometrial cancers in excess of those expected on the basis of the underlying secular trend, has been related to the use of postmenopausal estrogen therapy.[3] Additional risk factors may be related to estrogenic effects, including obesity, a high-fat diet, polycystic ovarian syndrome, tamoxifen use and reproductive factors such as nulliparity, early menarche, and late menopause.

Women with hereditary nonpolyposis colorectal cancer (HNPCC) syndrome have a markedly increased risk of endometrial cancer compared with women in the general population. Among women who are HNPCC mutation carriers, the estimated cumulative incidence of endometrial cancer ranges from 20% to 60%.[4,5]

Compared with white Americans, endometrial cancer incidence is lower in Japanese Americans (relative risk [RR] = 0.6; 95% confidence interval [CI], 0.46-0.83) and in Latinas (RR = 0.63; 95% CI, 0.46-0.87), but not in African Americans (RR = 0.76; 95% CI, 0.53-1.08) or in native Hawaiians (RR = 0.92; 95% CI, 0.58-1.46).[6] Higher mortality from endometrial cancer in African Americans is at least partly attributable to lower socioeconomic issues that impair access to care.[7]

Factors that have been associated with a decreased incidence of endometrial cancer include parity, lactation, use of combined oral contraceptives, a diet low in fat and high in plant foods, and physical activity.

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