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Reproductive Factors and the Risk of Endometrial Cancer

Ali, Aus Tariq BSc, MSc, PhD

International Journal of Gynecological Cancer: March 2014 - Volume 24 - Issue 3 - p 384–393
doi: 10.1097/IGC.0000000000000075
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Endometrial cancer is the most common malignancy of women in developed countries, and its incidence is 10 times higher than in developing countries. Endometrial cancer is most common in the sixth and the seventh decades of life; thus, postmenopausal women have a higher risk of developing the disease compared with premenopausal women. The increased incidence and prevalence of endometrial cancer can be explained by the increase in life expectancy, increased caloric intake, increased obesity rates, and other changes in lifestyle and reproductive factors. Among the reproductive factors, the risk of endometrial cancer is positively correlated with a younger age at menarche and late age at menopause, infertility, null parity, age of the first child, and long-term use of unopposed estrogens for hormone replacement therapy. Protection against endometrial cancer has been detected with increase parity, the use of combined oral contraceptives, and increased age of women at last delivery. The relationship between endometrial cancer risk and miscarriage, abortion, ovulation induction drugs and in vitro fertilization is still controversial.

Department of Chemical Pathology, Stellenbosch Medical School, Tygerberg Hospital, Cape Town, South Africa.

Address correspondence and reprint requests to Aus Tariq Ali, BSc, MSc (Nutrition), MSc (Medicine), PhD (Chemical Pathology), Department of Chemical Pathology, Tygerberg Hospital, 7505 Cape Town, South Africa. E-mail:

The author declares no conflict of interest.

Received January 2, 2013

Accepted November 26, 2013

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.