Elevated Body Mass Index as a Predictor of Cervical Cancer and Precancerous Lesions

BACKGROUND Cervical cancer (CC) is the fourth most frequent cancer and fourth leading cause of death in women. In 2020, 604 000 new cases and 342 000 deaths worldwide were estimated. According to the Global Cancer Observatory, the incidence of CC in Indonesia increased from 9.2% in 2020 to 16.8% in 2022. Obesity is associated with increased CC morbidities. A meta-analysis showed significant relationship between high BMI and elevated risk of developing female reproductive tumors, including cancer. This study aims to identify the association between BMI and CC and precancerous cervical lesions (PCL) in screened women. MATERIAL AND METHODS The study was conducted at Province General Hospital Margono, Indonesia, involving patients registered in 2022-2024 who had positive visual inspection with acetic acid test results and underwent the large loop excision of the transformation zone (LLETZ) procedure, with available histopathology results. Patients were classified into normal BMI and overweight/obesity BMI groups. Association between BMI and CC or PCL was analyzed. RESULTS Analysis of patients' BMI with histopathologically confirmed CC and PCL vs those without showed 26 (41.3%) of 63 patients with abnormal BMI had CC or PCL. BMI was significantly related to occurrence of CC and PCL (OR 3.033; 95% CI 1.034-8.899; P=0.04), indicating patients with abnormal BMI have 3.033-fold higher risk of developing CC or PCL than those with normal BMI. CONCLUSIONS Obesity is an underrated risk factor in women with a higher-than-normal BMI to have increased probability of developing CC or PCL. Higher BMI worsens the progressivity of the disease and health burden.