Risk Factors for Endometrial Cancer in the World: A Narrative Review of the Recent Literature

Objective: Endometrial cancer is the sixth most common cancer in women. Extensive studies have been conducted around the world to determine the risk factors of endometrial cancer. Although each of these studies provides useful findings, review studies provide a clear view of the different aspects of a phenomenon. Therefore, this review study was conducted to determine the risk factors of endometrial cancer in the world. Mechanism: A comprehensive search was conducted in Medline, Web of Science Core Collection (Indexes = SCI-EXPANDED, SSCI, A&HCI Timespan), and Scopus databases with the keywords; "endometrial cancer", "endometrial carcinoma", "endometrial neoplasm", "risk factor" and a combination of these words to find quality articles published from 2000 to 2024. Findings in brief: According to the literature, demographic factors, reproductive factors, gynecological factors, hormonal factors, lifestyle factors, medical conditions, and drugs can contribute to endometrial cancer. The study findings indicated that higher parity, oral contraceptive use, and regular physical activity may reduce the risk of developing endometrial cancer. Conversely, advanced age, prolonged reproductive period, infertility, polycystic ovary syndrome, postmenopausal hormone therapy, obesity, alcohol consumption, metabolic syndrome, and diabetes are associated with an increased susceptibility to this type of cancer. Conclusions: The findings of this study showed that reproductive factors such as early menarche, late menopause, nulliparity, and infertility increase the risk of endometrial cancer. Evidence shows that obesity, metabolic syndrome, and diabetes play a role in the occurrence of endometrial cancer. Although the use of menopausal hormone therapy increases the risk of endometrial cancer, the use of combined oral contraceptives is associated with a reduced risk.