Current perspectives on endometrial cancer in Portugal: prevention, diagnosis, clinical management, challenges and opportunities

Endometrial cancer (EC) is one of the most common gynecological malignancies, with a rising global incidence driven by increasing obesity rates and aging populations. This growing burden highlights the need for enhanced prevention strategies, early detection, and equitable access to innovative treatments. This paper presents an expert-driven perspective on the current state of EC care in Portugal, addressing epidemiology, risk factors, diagnostic pathways, therapeutic innovations, and health policy challenges. Based on expert panel discussions and a structured questionnaire, key barriers were identified, including diagnostic delays, limited integration of molecular profiling, and unequal access to emerging therapies such as immunotherapy. Despite high adherence to National and European clinical guidelines, disparities in treatment access persist due to regulatory and financial constraints. Public health strategies targeting risk reduction, timely and enhanced diagnostic pathways, and expansion of treatment availability are needed. Experts emphasized the critical need for hospitals to adopt molecular classification, given its key role in guiding decisions on adjuvant treatment. In addition, the limited availability of certain emerging tests was noted as a challenge to the broader adoption of precision oncology. By bridging gaps in prevention, diagnosis, and treatment, this paper aims to support healthcare professionals, researchers, and policymakers in optimizing EC care and improving patient outcomes in Portugal.