Young women repeatedly exposed to abdominal obesity are more likely to develop endometrial cancer (EC), according to a large nationwide study published recently in the International Journal of Obesity.
These results point to the waistline, rather than general weight alone, as a stronger predictor of cancer risk in this age group. This analysis followed 445,791 South Korean women aged 20 to 39 who completed four annual health exams between 2009 and 2012. None had cancer at the start.
“Cumulative exposure to abdominal obesity in young women is associated with a progressively increased risk of endometrial cancer,” the authors wrote. “In addition, abdominal obesity showed a stronger association with the risk of endometrial cancer than did general obesity, particularly as cumulative exposure increased.”
Researchers tracked abdominal obesity, defined as a waist size of at least 85 centimeters, and monitored for new cases of EC through 2020. Over a median of 7.12 years, 302 participants, with an average age of about 33, were diagnosed with EC.
Read more about causes and risk factors of EC
The risk of developing the disease rose steadily with each additional year of abdominal obesity. Women with one episode had about a 1.5-fold higher chance compared with those with none, while those with four consecutive episodes had more than a sixfold increased risk.
Incidence rates reflected this climb: from 0.08 cases per 1,000 person-years in women with no abdominal obesity to 0.66 cases per 1,000 person-years in those with four exposures. Even after accounting for age, blood pressure, diabetes, smoking, alcohol use, physical activity, and income, the pattern remained consistent.
This study also compared abdominal obesity with general obesity measured by body mass index. Both increased cancer risk, but abdominal obesity showed a clearer, more linear relationship. This suggests fat carried in the midsection may be especially harmful for younger women, possibly because it is more closely tied to metabolic changes and hormone disruptions that fuel tumor growth.
For patients, these results highlight the importance of tracking waist size, not just body weight. Reducing abdominal fat through healthy eating and regular physical activity could help lower the chance of developing endometrial cancer later. Doctors may also consider paying closer attention to waist measurements in younger women when discussing cancer prevention.
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