Uterine cancer is deemed to be the most common gynecologic malignancy in developed countries. Despite all the breakthroughs, the issue has received considerable critical attention as the mortality rate for uterine cancer is on the rise. This elevated incidence could be multifactorial (Siegel et al., 2012; Niyazi et al., 2016). The raised prevalence of endometrial cancer in US-born generations of Chinese and Japanese Americans when compared with their counterparts who were born in Asia demonstrated that the exposure to some environmental features or lifestyle modifications may alter the race-specific factors of this malignancy (Frumovitz et al., 2014).
The association of endometrial cancer with such dominant characteristics as age, BMI, race, familial history, and polycystic ovary, diet, physical activity, smoking, parity, breastfeeding, birth rate, hormone-replacement therapy, hypertension, diabetes, histology, the socio-economic status, and the exposure to infertility treatment are still controversial in terms of incidence and mortality (Brinton et al., 1992; Salazar-Martínez et al., 2000; Soliman et al., 2005; Beral et al., 2007; Zhou et al., 2008; Furness et al., 2009; Liat et al., 2012; Liao et al., 2014; Filomeno et al., 2015). Several attempts have been made to distinguish the contributing factors behind Type I endometrial cancer from Type II. Flix et al. (2010) concluded that type 2 was associated with excess age, nonwhite race, and the history of additional primary tumors.
Renehan et al. (2008) also recognized that excess adiposity played a critical role. Despite all the reported data, much uncertainty still exists about the factors associated with uterine cancers in the developing and less developed countries. The limited knowledge of the known symptoms, the late diagnosis at a higher-grade phase of the disease, the poorer quality of life, and the impaired socioeconomic status make women in developing and less developed counties more vulnerable to endometrial cancer (Soliman et al., 2008; Hirth et al., 2016). Research on the issue has been mostly limited to imperfect statistics from women who were involved with uterine malignancy prior to higher-grade stages, patients who died of cancer at home and those with misdiagnosis of metastases from organs adjacent to uterine. Accordingly, these women suffer disproportionately from adverse disease-specific prognosis of endometrial malignancy.
