Identifying areas at risk of endometrial cancer increase in Latin America: development of a geospatial model

Abstract

Endometrial cancer is presently the most common gynaecological cancer in high-income countries due to factors such as population aging and obesity, which leads to high oestrogen concentrations and is linked to abnormal endometrial cell proliferation. Obesity is a global health issue; more than 20% of people in Latin America are currently obese, and approximately 58% are overweight. The purpose of this study was to analyse obesity rates and the evolution of the female population older than 65 years of age in Latin American and Caribbean countries, mapping areas at high risk of increase in the incidence of endometrial cancer in the coming years. This is an ecological study based on data on endometrial cancer incidence and mortality rates, obesity prevalence, and female population older than 65 years of age, available from the International Agency for Research on Cancer and Pan American Health Organization databases. Data were mapped individually and then combined and analysed to identify potential priority areas for intervention. Currently, Brazil, Mexico, Argentina, Cuba, and Chile are the Latin American countries with the highest endometrial cancer incidence. Puerto Rico, Uruguay, Cuba, Chile, and Argentina are those with the highest proportion of women aged 65 years or older. The highest rates of obesity are currently seen in Mexico, Argentina, Chile, and Barbados. Our analysis shows an overlap of both highest age and obesity rates in Argentina, Mexico, Barbados, and Chile. The incidence of endometrial cancer is increasing worldwide. Low-income and middle-income countries, where access to treatment can be limited, need to prepare for this rising incidence. Georeferenced information integrating available health data enables the identification of clinically vulnerable populations to further outline tailored strategies. Mexico, Argentina, Chile, and Barbados are, concurrently, in the highest quartile of obesity and proportion of women aged 65 years or older, and therefore at the greatest risk of a rising incidence of endometrial cancer in the near future. Coordinated actions to increase prevention, awareness, and health system preparedness should be taken by policy makers. None.