Diabetes, Obesity, and Endometrial Cancer: A Review

Area of Science:

• Oncology
• Endocrinology
• Public Health

Background:

• Endometrial cancer (EC) is a leading cancer in U.S. women.
• Diabetes and obesity are known independent risk factors for EC.
• The combined impact of diabetes and obesity on EC risk and progression is less understood.

Purpose of the Study:

• To review existing literature on diabetes and obesity as risk factors and modifiers of endometrial cancer.
• To synthesize evidence on the combined effects of these comorbidities on EC.
• To explore the mechanistic links and impact on treatment outcomes.

Main Methods:

• Systematic review of cohort and case-control studies.
• Analysis of relative risk (RR) and odds ratios (OR) for EC in women with diabetes and/or obesity.
• Examination of data on treatment complications, survival rates, and cancer-specific mortality.

Main Results:

• Coexisting diabetes and obesity substantially elevate EC risk, with RRs up to 6.39 and ORs up to 5.1 compared to diabetes alone.
• Adding low physical activity further amplifies EC risk (RR up to 9.61).
• These comorbidities are associated with increased surgical complications, thromboembolic events, prolonged hospitalizations, and poorer survival (HR=2.65 for cancer-specific mortality).

Conclusions:

• The combination of diabetes and obesity presents a significantly heightened risk for endometrial cancer.
• These comorbidities create a pro-cancerous microenvironment via metabolic and inflammatory pathways.
• Urgent need for targeted interventions and further research on managing these comorbidities in EC patients to improve outcomes.