Preventing Endometrial Cancer
Gynaecological cancers and Lifestyle
In the US alone, there were an estimated 50,000 new cases of endometrial cancer (EC) and >10,000 EC-related deaths in 2015. 1,2 Obesity and sedentary behaviour significantly contribute to risk of EC, specifically for type 1 (estrogen depression).
Obese women have 2.4–4.5 times the risk of being diagnosed with EC and incidence rates in obese women aged < 50 years increased by 2% each year from 1992 to 2012.1
20%–30% reduction in EC risk in women who report moderate or high intensity exercise daily walking in otherwise sedentary women reduces risk. The ACS Prevention Study II Nutrition suggested that women at the highest risk may glean the most benefit.3
Diets with high glycemic loads increased EC risk by up to 20% in two large meta-analyses of cohort and case–control studies (RR =1.2, 95% CI 1.06–1.37 and 95% CI 1.09–1.33). A meta-analysis found no effect of dairy on EC risk. Results suggest that sugar-sweetened beverages and diets with high glycemic load should be avoided. 1
Coffee, tea, alcohol, and other beverages
Coffee consumption may lower EC risk: a meta-analysis of 13 cohort studies found a dose–response relationship and an overall reduced risk of EC with coffee consumption (RR =0.80, 95% CI 0.74–0.86 for highest vs lowest coffee drinkers). Similar reductions have been noted with green tea consumption, but not black tea. 1
Oral contraceptives pills (OCP)
Longer use of OCP resulted in lower EC incidence, and the effects persisted for at least 30 years after cessation of use. Despite reductions in OCPs’ oestrogen content since the 1960s, the risk reduction was the same, suggesting that the progesterone effect was similar regardless of oestrogen dose. 4
Tips to maximize the health benefits from Eggplant
Other contraceptive types
Injectable progestin (depot medroxyprogesterone acetate) is similarly protective against EC, with effects lasting up to 8 years (RR =0.21, 95% CI 0.06–0.79). For levonorgestrel intrauterine devices (IUDs), 31% reduction in odds of EC was found. 1
A recent meta-analysis found that breastfeeding reduces the risk of EC by 33% and with each 1 month of breastfeeding duration, risk of EC was reduced by 2% (RR 0.98, 95% CI 0.97–0.99). 5
Summary and recommendations
Women at risk for EC should be counseled on the benefits of increasing physical activity, even light or moderate activity, as well as the benefits of weight loss for EC risk reduction. Morbidly obese women (BMI ≥40 kg/m2) should be counseled about the health benefits of bariatric surgery, including the impressive EC risk reduction. While no particular diet appears to reduce EC risk, sugar-sweetened beverages and diets with high glycemic load should be avoided. Women should also be counseled about the benefits of EC risk reduction with progestin-containing contraceptives.
Lifestyle factors, such as overweight/obesity and sedentary living, increase the risk of developing EC and ovarian cancer (OC). As low- and middle-income countries undergo transition to a Western sedentary lifestyle and are further burdened by obesity, addressing modifiable risk factors today become even more important to minimize the gynaecologic cancer burden and optimize survivorship globally.