92 A recent study has highlighted a significant increase in the incidence of uterine cancer in Sarawak, particularly among older women and certain ethnic groups. The 20-year review, published in the Asian Pacific Journal of Cancer Prevention, analysed data from the Sarawak Cancer Registry, revealing a worrying upward trend in uterine cancer cases across the region. Between 1996 and 2015, 811 women were diagnosed with primary uterine cancer in Sarawak. The study found that the overall crude incidence rate for uterine cancer during this period was 3.7 per 100,000 women, with an age-standardised incidence rate (ASR) of 4.4 per 100,000. Notably, the incidence rate increased significantly over time, with the ASR in 2011-2015 being 1.6 times higher than in 1996-2000. The findings indicate that the risk of developing uterine cancer is particularly high among women aged 40 and above, with the majority of cases occurring in women aged 40-59 years. The study observed that women in this age group had a more than tenfold increased risk of developing uterine cancer compared to those aged 40 and below. Furthermore, women aged 60 and above showed a similarly high risk, underscoring the vulnerability of older women to this disease. Ethnic disparities were also evident in the study, with Chinese women showing the highest incidence rates, followed by Malay and Iban women. Chinese women had a 1.2-fold increase in ASR in 2011-2015 compared to 1996-2000, while the ASR for uterine cancer among Melanau women increased dramatically, rising fourfold over the 20-year period. These findings suggest that certain ethnic groups in Sarawak may be more susceptible to uterine cancer, although the underlying reasons for these disparities remain unclear. Geographical differences within Sarawak were also noted, with Kuching, Sibu, and Miri divisions recording the highest incidence rates of uterine cancer. Kuching, the capital of Sarawak, had the highest ASR at 4.8 per 100,000, which may be attributed to variations in lifestyle factors, healthcare access, and possibly environmental influences. The study also delved into potential risk factors for uterine cancer, highlighting the role of obesity as a major contributor. The prevalence of obesity has increased significantly in Malaysia over the years, with more than half of the uterine cancer cases potentially linked to this condition. Other risk factors identified include diabetes, early menarche, late menopause, and the use of hormone replacement therapy (HRT). The study noted that women who undergo HRT, particularly oestrogen-only therapy, face a heightened risk of developing uterine cancer. The results of this study underscore the growing burden of uterine cancer in Sarawak and point to the need for targeted public health interventions. Increased awareness, early detection, and lifestyle modifications could play a crucial role in mitigating the risk of uterine cancer, particularly among older women and high-risk ethnic groups.