Abdominal Obesity and Endometrial Cancer in Egyptian Females With Postmenopausal Bleeding

Abstract

Endometrial cancer is the most common type of female genital tract malignancies. We intended to assess the relation between different measures of obesity and the risk to develop endometrial cancer in Egyptian females with postmenopausal bleeding (PMB). The study was conducted in Alexandria, Egypt and included all postmenopausal females presenting to the University Hospital of Gynecology and Obstetrics with PMB within the study period (from January 1 to September 30). A questionnaire was completed, and data about anthropometric measurements including weight, height, and waist circumference were collected. Vaginal sonography, dilatation and curettage, and pathological examination were done by experts for all participants. Endometrial cancer was diagnosed in 38% of females presenting with PMB. Using ROC curve analysis, only the measure of abdominal obesity (waist circumference) showed significant accuracy in predicting endometrial cancer (area = 0.63, P < .05). The best cutoff point that maximizes accuracy was 88 cm. Body mass index (≥30 vs. ≤30) showed no significant relation (OR = 1.1, 95%CI 0.5-2.3), and the ratio between upper and lower body obesity (W/H ratio) showed border line significant relation (OR = 2, 95% CI 1-4.1), whereas waist circumference (≥88 vs. ≤88 cm) showed strikingly high OR (OR = 13.6, 95%CI 4-46.6). The risk of abdominal obesity on endometrial cancer remains very high (OR = 15.8, 95%CI 4.1-60.9) even after adjustment, in a logistic model, for other risk factors such as age at presentation, age at menarche, age at menopause, family history of malignancy, and gravidity. Abdominal obesity (waist circumference >88 cm) is the best measure of obesity to be used in predicting the risk of endometrial cancer in Egyptian females with PMB.

Gynecological Cancer Services in Arab Countries: Present Scenario, Problems and Suggested Solutions

“…These risk factors are probably similar to most other cancers including unhealthy life style, obesity, smoking and poor diet. Obesity epidemic is global; however it is more prevalent in some rich Arab countries (El-Hazmi and Waresy, 1997;Zaghloul et al, 2011;Zaki et al, 2011). Tackling of obesity epidemic in these countries can reduce the incident of obesity related cancers like endometrial cancer.…”

Obesity Prevelance in West Black Sea Region: The Melen Study

“…Yapılan çalışmalar kardiyovasküler mortalitenin kadınlarda daha yüksek olduğu ve VKİ >29 olanlar ile VKI<19 olanlar arasında kardiyovasküler mortalite açısından 4 kat fark olduğunu göstermektedir (19). Menopoz durumu ne olursa olsun obez kadınlarda normal kilolu kadınlara oranla hastalık gelişme riski 2-4 kat daha yüksektir (20,21). Çalışma popülasyonumuzdaki kadınların %53,1'inde obezite olması nedeniyle kadın popülasyonunun hem DM, KAH, HT gibi kronik hastalıklar hem de özellikle endometrium kanseri olmak üzere maligniteler yönünden ciddi risk altında olduğu söylenebilir.…”

Expression and significance of PTEN and GLUT-1 in proliferative endometrium, endometrial hyperplasia, and endometrioid adenocarcinoma

“…In Egypt, endometrial cancer accounted for 2.6% of the total female neoplasms (Salim et al, 2009). It was diagnosed in 38% of Egyptian women presenting with perimenopausal bleeding (Zaki et al, 2011). Endometrioid endometrial carcinoma (EECA) accounts for more than three-fourths of endometrial cancers and is thought to develop following a continuum of premalignant lesions, ranging from endometrial hyperplasia without atypia, to hyperplasia with atypia and finally to well-differentiated carcinoma (Boruban et al, 2008;Monte et al, 2010).…”