Unopposed Estrogen and Endometrial Carcinogenesis: Current Concepts

Abstract

Endometrial carcinoma represents the sixth most frequently diagnosed malignancy affecting the female genital tract globally.¹ In 2020, approximately 417,000 new cases were identified worldwide, accompanied by an estimated 97,000 related deaths.² Across Europe, the burden of disease remains substantial, with projections indicating 124,874 newly diagnosed cases and 30,272 deaths in 2022.^3-5 The incidence of endometrial cancer continues to increase, largely driven by demographic aging and the rising prevalence of obesity. Over a woman’s lifetime, the risk of developing endometrial cancer is estimated at around 3%, with a median age at diagnosis of 61 years.⁶ Notably, the global incidence has risen by approximately 132% during the past three decades, underscoring the expanding impact of key risk factors, particularly obesity and population aging.