Being overweight or obese have been shown to be significant risk factors for the development of endometrial cancer, due to their influence on hormonal and metabolic levels. Weight gain is associated with higher levels of oestrogen, which may promote the development of endometrial cancer. Additionally, people who are obese have higher levels of certain proteins and inflammatory factors in their blood, which can also increase the risk of endometrial cancer.
Various factors such as body mass index (BMI) have been studied to verify this statement. BMI is a common measure of body fat, and each 5-unit increase in this index has been associated with a 50% increase in the risk of developing endometrial cancer. This means that an overweight woman is about 1.5 times more likely to develop endometrial cancer than a woman of healthy weight; while a woman in the ”obese” range has 2-10 times the risk.
Other methods of measuring body adiposity, such as waist size, adult weight gain and waist-to-hip ratio, have also been associated with an increased risk of developing endometrial cancer. For example, every 10 cm increase in waist size has been linked to a 27% increase in the risk of endometrial cancer.
As obesity among young women continues to rise, more young women are diagnosed with endometrial cancer each year. This has an impact on the clinical management of these patients, since the possibility of preserving their ovaries during endometrial cancer surgery should be considered, as well as the use of treatments that preserve fertility.
The standard treatment for endometrial cancer, especially in the early stages, involves a total hysterectomy . This surgical intervention is usually performed using minimally invasive techniques, such as laparoscopy or robotic surgery. It involves the removal of the uterus, both ovaries and the fallopian tubes, as well as sentinel lymph node detection.
For young women diagnosed with endometrial cancer, ovarian preservation may be an option to consider to maintain hormonal function and quality of life after treatment. However, it is crucial to carefully evaluate each case, considering factors such as the extent and grade of the cancer, the patient's age, treatment plans such as radiotherapy and chemotherapy, as well as the patient's reproductive expectations and desires.
It is essential the decision is made on an individual basis, with the participation of a multidisciplinary team that includes oncologists, gynaecologists specialised in cancer, endocrinologists and fertility specialists The goal is to find a balance between effective cancer treatment and preserving the patient's long-term ovarian function and quality of life.
