Endometrial cancer is a disease of older (usually postmenopausal) women. More than 95% of these cancers occur in those over the age of 40 with an average age at the time of diagnosis of 63. Postmenopausal women are at high risk for endometrial cancer if they:

• began menstruating early.
• went through menopause late.
• are obese.
• have diabetes or high blood pressure.
• have a history of inherited colorectal cancer.
• have few or no children.
• have a history of infertility, irregular menstrual periods, or endometrial hyperplasia.
• have a family history of endometrial, colon, or breast cancer.

Women taking the drug tamoxifen to treat or prevent breast cancer are at very slightly increased risk. But women who have taken birth-control pills are only half as likely to develop the disease after menopause as those who have not.

Risk for endometrial cancer is linked to the amount of the female hormone estrogen that the endometrium has been exposed to during the woman's lifetime, since estrogen stimulates cell formation. Women who have had a long span of menstruation have a higher risk of endometrial cancer.

Modern postmenopausal hormone therapy (HT or HRT) has very low doses of estrogen and progesterone, another female hormone that suppresses cell formation. The new HTs do not increase a women's risk for endometrial cancer. Nonetheless, women on HT should get regular exams. Women using estrogen only without progesterone have increased risks of endometrial cancer.

Rare ovarian tumors can produce estrogen and increase a woman’s chance of developing cancer of the uterus.

Recent research has focused on the findings that high fat diets, especially containing red meat, can increase several cancers including endometrial cancer. It has been suggested that fatty foods with high fat and caloric content leads to obesity, which is well known to be linked to increased endometrial cancer. "Fat tissue" can change hormones into estrogen. Obesity has been linked to breast cancer and thus women who have had breast cancer may have a higher risk for endometrial cancer.

Hormone replacement therapy can be given to women with treated endometrial cancer as it is not associated with an increased risk of recurrence of endometrial cancer or death resulting from it. It is also not linked to the development of new cancers.

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