{
  "abstract": "Background\n\nEndometrial cancer (EC) is the most common gynaecologic cancer in the USA and a major cause of cancer-associated mortality among women. We aimed to identify the independent contributions of individual- and contextual-level factors to EC incidence.Methods\n\nWe conducted a longitudinal retrospective cohort study using anonymised data from women aged 18 years and above without EC included in the All of Us Research database before 1 January 2017. We followed participants from study entry until October 2023 (median follow-up = 6.6 years). We used mixed-effects Cox regression models to examine data from individuals nested within ZIP-code areas and states, analysing individual-level risk factors and neighbourhood-level socioeconomic predictors in addition to adjusting for area-level clustering.Results\n\nOf 81,171 eligible women followed for 496,709 person-years, 778 (0.96%) developed EC. The risk of EC risk approximately thrice as high among women aged 50-59 years (adjusted hazard ratio (aHR) = 2.92; 95% confidence interval (CI) = 2.20-3.88), 60-69 years (aHR = 2.97; 95% CI = 2.21-4.00), and ≥70 years (aHR = 2.86; 95% CI = 2.02-4.06) than among women under 40 years of age. Non-Hispanic White women had a 44% higher risk than non-Hispanic Black women (aHR = 1.44; 95% CI = 1.15-1.80). Obesity was associated with more than twice the risk of EC (aHR = 2.16; 95% CI = 1.85-2.52), while diabetes was associated with a 27% higher risk (aHR = 1.27; 95% CI = 1.06-1.51).Conclusion\n\nIndividual-level factors, particularly age and obesity, were the main predictors of EC incidence. Prevention efforts should prioritise obesity reduction, age-specific screening awareness, and lifestyle modifications.",
  "abstract_shown": true,
  "affiliations": [
    "Center for Interdisciplinary Research in Women's Health, School of Medicine, The University of Texas Medical Branch, Galveston, Texas, USA.",
    "Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas, USA.",
    "Department of Biostatistics and Data Science, The University of Texas Medical Branch, Galveston, Texas, USA.",
    "School of Medicine, The University of Texas Medical Branch, Galveston, Texas, USA.",
    "Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, Texas, USA.",
    "Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA.",
    "Division of Health Sciences, Warwick-Centre for Applied Health Research and Delivery, The University of Warwick, Coventry, UK."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Victor Adekanmbi"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Fangjian Guo"
    },
    {
      "affs": [
        2
      ],
      "name": "Jiefei Wang"
    },
    {
      "affs": [
        3
      ],
      "name": "Angela Zhang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Christine H Wang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Thao N Hoang"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Itunu Sokale"
    },
    {
      "affs": [
        6
      ],
      "name": "Olalekan Uthman"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Abbey B Berenson"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/96hay2qz3991c.bib",
  "cited_by": 0,
  "doi": "10.7189/jogh.16.04368",
  "fulltext_url": "https://europepmc.org/articles/PMC13693290",
  "id": "96hay2qz3991c",
  "issns": [
    "2047-2978",
    "2047-2986"
  ],
  "landing_url": "https://europepmc.org/article/MED/42924636",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2729|Endometrial and Cervical Cancer Treatments"
    ]
  ],
  "openalex": "W7223292421",
  "pdf_url": "https://europepmc.org/articles/PMC13693290?pdf=render",
  "pmcid": "PMC13693290",
  "pmid": "42924636",
  "published": "2026-10-23",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/96hay2qz3991c.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "MED:42924636",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42924636"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2729|Endometrial and Cervical Cancer Treatments",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Risk factors for endometrial cancer incidence and regional and ethnic disparities in the USA.",
  "title_text": "Risk factors for endometrial cancer incidence and regional and ethnic disparities in the USA.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/96hay2qz3991c",
  "venue": "Journal of global health",
  "versions": []
}