More women around the world are being diagnosed with endometrial cancer than ever before, and experts believe the increase has everything to do with the primary risk factor for the disease: obesity. Between 1978 and 2013, endometrial cancer diagnoses have increased in 26 of 43 countries, according to an October study published in the Journal of the National Cancer Institute. The rise mirrors worldwide obesity data from the World Health Organization, which found that, between 1975 and 2016, obesity rates tripled.
“ When the rate of endometrial cancer's biggest risk factor increases, it's only natural that the incidence of endometrial cancer would rise, too.” - Julian Schink, MD - Chief of Gynecologic Oncology
How common is endometrial cancer?
Endometrial cancer, the most common form of uterine cancer, is the fourth most common cancer in women in the United States, and the most common cancer of the female reproductive system. The disease forms in the lining of the uterus, with an estimated 80 percent of cases linked to high levels of estrogen. Body fat produces estrogen, and excess amounts of the hormone may cause the uterine lining to thicken. When that happens, cancer is more likely to develop.
Shifts in reproductive trends may also be contributing to the growing endometrial cancer rates, Dr. Schink says. For example, more women are having fewer children, and more women are delaying childbirth until later in life. Endometrial cancer is also more common in postmenopausal women, and women are living longer than prior generations, which may also factor into the rising rates. In fact, in all the countries included in the Journal of the National Cancer Institute study, incidence rates were four to 20 times higher in women aged 50 and older.
What can I do?
Still, obesity is the single most defining cause, and concern, Dr. Schink says. Women can help lower their risk for the disease by losing weight, and by taking progesterone, a female hormone that regulates how the inner lining of the uterus forms. “Progesterone may cause hunger, though, and that’s not helpful in women who are already dealing with obesity,” Dr. Schink says. “It also causes vaginal bleeding and spotting, and makes many women feel bloated and depressed. So it’s not ideal.”
The link between obesity and endometrial cancer presents an important opportunity, Dr. Schink says. “A preventive health study needs to be conducted on this patient population,” he says. “People have talked about it, but it hasn’t gotten off the ground yet. We need to have some targeted interventions or strategies for people who are obese. And they need to include screening for endometrial thickness, so we can intervene when precancerous changes have been detected.”
