Endometrial cancer is the most prevalent type of female genital tract malignancy in the developed countries. It represents nearly 50% of all new genital cancers in the Western world, surpassing the incidence of cervical cancer. Endometrial cancer is a disease of postmenopausal women (median age 63 years) and 90% of cases occur in patients over 50 years of age. Clinical risk factors include early onset of menstruation, obesity, sedentarism, nulliparity, infertility, late menopause, diabetes mellitus, hypertension, estrogen exposure and prolonged tamoxifen treatment. Some 5% of endometrial cancers are associated with hereditary non-polyposis colorectal carcinoma (Lynch syndrome type II). There are different subtypes of endometrial cancer but the most common is the endometrioid type (90% of cases). Other subtypes are papillary, serous, clear cell carcinoma and carcinosarcomas. Endometrioid cancer has a good prognosis, while the other subtypes are associated with a bad prognosis.
Abdominal obesity is a well-established risk factor for endometrial cancer, but mechanisms underlying the association are unclear. Luhn and colleagues  recently reported the influences of serum estradiol, adiponectin, leptin and visfatin on endometrial cancer risk in a nested case–control sample of postmenopausal women included in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. The studied population included 167 incident endometrial cancer cases and 327 matched controls with similar sociodemographic characteristics. Estradiol and adipokine (adiponectin, leptin and visfatin) levels were categorized into tertiles (T). Conditional logistic regression showed inverse association between adiponectin levels (T3 vs. T1) for the risk of endometrial cancer (odds ratio (OR) 0.48; 95% confidence interval (CI) 0.29–0.80), while high leptin levels had a positive association (OR 2.77; 95% CI 1.60–4.79). The associations were stronger when considering only women not using menopause hormone therapy. There were non-significant associations between serum visfatin levels and endometrial cancer risk.
Faustino R. PÃ©rez-LÃ³pez
Professor of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine & Lozano Blesa University Hospital, Zaragoza, Spain
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