Obesity and Endometrial Cancer: A Lack of Knowledge but Opportunity for Intervention

Abstract

Objective: The causal link between obesity and endometrial cancer is well-established, however obese women’s knowledge of this relationship is unknown. Our objective was to explore patients’ understanding of this relationship and assess the acceptability of a technology-based weight loss intervention. Methods/Materials: Obese women with Type I endometrial cancer/hyperplasia were surveyed about their assessment of their body mass, knowledge of the relationship of obesity and endometrial cancer, and eating and activity habits. Interest in participation in an intervention also was assessed. Results: Eighty-one women with early stage (71.6% stage I) and grade (41.7% grade 1) disease completed the survey. The median BMI was 35.4 kg/m2 (IQR 32.2–43.5 kg/m2) and the average age was 59.3 (SD 11.1) years. 76.25% of women were unable to categorize their BMI correctly and 86.9% of those incorrectly underestimated their BMI category. One-third (35.9%) were unaware of any association between obesity and endometrial cancer and 33.3% responded that obesity decreased or did not significantly increase the risk of endometrial cancer. 59% expressed interest in a weight loss intervention. Conclusions: Endometrial cancer survivors with obesity underestimated their obesity and lacked knowledge regarding the link between obesity and endometrial cancer. However, the majority expressed interest in electronically delivered weight loss interventions.

Obesity Epidemic—The Underestimated Risk of Endometrial Cancer

“…The question of weight loss is relevant as Haggerty and colleagues pointed out in 2017. They conducted a survey among patients with stage I EC and found that 59% of the patients reported great interest in using weight loss as a preventive method against recurrence [ 3 ].…”

“…Increasing body mass index (BMI) is a phenomenon being seen not only in the classical Western world but also in developing countries [ 1 , 2 ]. Indeed, one-third of American women are obese, defined by a BMI > 30 kg/m 2 , with about 7% presenting with severe or morbid obesity (BMI > 40 kg/m 2 ) [ 3 ]. There is a strong, well-established association between obesity and the development of endometrial cancer (EC) [ 4 , 5 ].…”

“…However, many women are still not aware of this very individual risk factor [ 3 , 9 ]. Thus, there is a strong demand to improve the common understanding of the relationship between adiposity and EC and to offer therapeutic and behavioral strategies.…”

Biological Omics Analysis of Tumor Mutation Burden Combined with Immune Infiltrates in Uterine Corpus Endometrial Carcinoma

“…According to the pathogenesis and biological behavioral characteristics, UCEC can be divided into estrogen-dependent type (type I) and non-estrogen-dependent type (type II) (4). Approximately 40% of cases are related to obesity (5,6). Besides, endometrial cancer is also associated with excessive estrogen exposure, hypertension, and diabetes.…”

Patients with endometrial cancer continue to lack understanding of their risks for cancer

“…Obesity has been shown repeatedly to be one of the strongest EC risk factors that drives all-cause and cancer-specific mortality (Gunderson et al, 2014; Arem et al, 2013; von Gruenigen et al, 2006). Appropriately, an abundance of research has been dedicated to better understanding patients' knowledge of the impact of obesity on cancer, and multi-centered weight loss interventions have been implemented among EC survivors to help reduce their risk of death (Ackermann et al, 2005; Connor et al, 2017; Haggerty et al, 2017a, Haggerty et al, 2017b; Kuroki et al, 2015; Soliman et al, 2008). Unfortunately, positive outcomes of weight loss interventions are brief and reach only a small subset of women affected with EC (Haggerty et al, 2017a).…”