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Epidemiologic Evidence for the Obesity-Endometrial Cancer Relationship

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Focus on Gynecologic Malignancies

Part of the book series: Energy Balance and Cancer ((EBAC,volume 13))

Abstract

There are convincing epidemiologic evidence that obesity increases endometrial cancer risk and consistent positive associations between body mass index (BMI) and other adiposity parameters and endometrial cancer risk have been observed across different study populations. Indeed, the risk of endometrial cancer is estimated to be 1.54-times higher per 5 kg/m2 increment increase in BMI—an association with BMI that is the strongest that has been observed for any type of cancer. The higher risk of endometrial cancer among overweight and obese women appears to be restricted to those who have not used postmenopausal hormone therapy, suggesting that the modulation of estrogenic activity may be a possible mechanism that underlies the obesity-endometrial cancer link. Further, circulating estrogen levels are positively associated with endometrial cancer risk and partly explain the obesity-endometrial cancer association in mediation models. Another key mechanism that may link obesity with endometrial cancer risk includes hyperinsulinemia as supported by both experimental and observational data. Inflammation and increased exposure to inflammatory cytokines derived from adipose tissue represent additional putative pathways that could contribute to the role of obesity in endometrial cancer development. This review summarizes results from epidemiologic studies on obesity (assessed as BMI, waist circumference and other measures) and endometrial cancer development, highlights mechanisms that may link obesity to endometrial carcinogenesis, and discusses areas of ongoing and future research that could help to develop improved strategies for endometrial cancer prevention.

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Authors and Affiliations

  1. Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, 96813, HI, USA

    Melissa A. Merritt

  2. Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), 150, Cours Albert Thomas, Cedex 08, 69372, Lyon, France

    Marc J. Gunter Ph.D.

Authors
  1. Melissa A. Merritt
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  2. Marc J. Gunter Ph.D.
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Correspondence to Marc J. Gunter Ph.D. .

Editor information

Editors and Affiliations

  1. Center for Science, Health and Society, Case Western Reserve University, Cleveland, Ohio, USA

    Nathan A. Berger

  2. Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA

    Ann H. Klopp

  3. Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, Texas, USA

    Karen H. Lu

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Merritt, M.A., Gunter, M.J. (2018). Epidemiologic Evidence for the Obesity-Endometrial Cancer Relationship. In: Berger, N., Klopp, A., Lu, K. (eds) Focus on Gynecologic Malignancies. Energy Balance and Cancer, vol 13. Springer, Cham. https://doi.org/10.1007/978-3-319-63483-8_1

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  • DOI: https://doi.org/10.1007/978-3-319-63483-8_1

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  • Online ISBN: 978-3-319-63483-8

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