Increasing evidence suggests that obesity plays a key role in the development of endometrial cancer (EC), according to a recently published study in Gynecologic Oncology Reports.
Endometrial cancer is the fourth most common malignancy in biological females in the U.S., and the only one with declining survival rates over the last 40 years.
Research shows that obesity is a primary driver of this trend, contributing to increased estrogen levels, chronic inflammation, and insulin resistance, all factors that promote endometrial proliferation and malignancy. However, the established link between obesity and cancer awareness remains low and many healthcare providers do not routinely address weight in cancer counseling.
According to clinical evidence, the mortality risk is up to six times higher in morbidly obese patients, and obesity contributes to earlier cancer onset, with increasing incidence in women aged 35 to 44. Other factors influencing EC outcomes include socioeconomic disparities. Minority communities face higher mortality and are less likely to access approved obesity treatments. Comorbidities like diabetes and PCOS further compound risk.
Statistics revealed that only a minority of endometrial cancer patients recall receiving weight-related counseling from their physicians, despite evidence showing such guidance increases dietary changes and weight loss attempts.
Other studies show that ketogenic diets, high-fiber regimens, and plant-based nutrition improve insulin sensitivity and may lower cancer risk. Exercise programs were also associated with measurable improvements in fitness and visceral fat reduction.
Pharmacologic options like metformin have mixed evidence for anticancer effects but support weight loss, especially when combined with progesterone-based therapies in younger patients pursuing fertility preservation. Newer agents like GLP-1 receptor agonists show promise in both weight reduction and potential anticancer effects, as evidenced in early trials and preclinical models.
Bariatric surgery remains the most effective long-term intervention. It significantly lowers cancer risk and improves metabolic markers, though findings on endometrial proliferation are inconsistent. Retrospective studies consistently show reduced cancer incidence post-surgery, and one case highlighted a complete treatment response after weight loss enabled by surgery.
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