From the Journals

Intentional weight loss protects against endometrial cancer

View on the News

Aggressive weight loss strategies may be warranted

Luo et al. showed that women who deliberately lost 5% or more of their body weight during a 3-year period reduced their long-term risk of endometrial cancer by nearly 30%, and obese women did so by 56%. At a minimum, clinicians should inform their patients about this association, especially because the link between obesity and endometrial cancer is clearly underrecognized.

But given the difficulty of losing weight, more aggressive strategies may be beneficial. Bariatric surgery and the use of progestational agents such as levonorgestrel IUDs warrant consideration.

Screening for endometrial cancer currently is very limited, so it also should be reassessed. Endometrial sampling and transvaginal ultrasound have drawbacks, including a lack of sensitivity and specificity in asymptomatic women. If more novel strategies prove reliable and cost-effective, including uterine lavage and collection of exfoliated cells from the cervix, they can be widely adapted into clinical practice.

Jason D. Wright, MD, is in the division of gynecologic oncology at Columbia University, New York, and New York Presbyterian Hospital. He reported having no relevant financial disclosures. Dr. Wright made these remarks in an editorial accompanying Dr. Luo’s report (J Clin Oncol. 2017 Feb 6. doi: 10.1200/JCO.2016.71.7991).


 

FROM THE JOURNAL OF CLINICAL ONCOLOGY

Among postmenopausal women, intentional weight loss protects against endometrial cancer, even if that loss is modest (5% or more), according to a report in the Journal of Clinical Oncology.

They focused on 36,793 women who participated in the WHI and who reported whether they had maintained a stable weight, lost 5% or more of their total weight, or gained 5% or more of their total weight during the first 3 years after enrollment. During a mean of 11.4 years of follow-up, 566 of these women developed endometrial cancer, said Juhua Luo, PhD, of the department of epidemiology and biostatistics, Indiana University School of Public Health, Bloomington, and her associates.

Women who lost weight intentionally showed a significantly lower risk of endometrial cancer than did those who had stable weight (HR, 0.71). This association was most pronounced among obese women: Those who lost at least 5% of their body weight intentionally showed a dramatic reduction in endometrial cancer risk (HR, 0.44). In contrast, unintentional weight loss was not associated with a lower risk of endometrial cancer. And women who gained 10 pounds or more during the first 3 years of the study showed a significantly higher risk of endometrial cancer, the investigators said (J Clin Oncol. 2017 Feb 6. doi: 10.1200/JCO.2016.70.5822).

In a sensitivity analysis, women who intentionally lost weight and achieved a normal BMI showed the same risk of endometrial cancer as that of those who had maintained a stable BMI throughout the study.

Recommended Reading

ASCO: Always screen cancer survivors for chronic pain
MDedge Family Medicine
Triptorelin doesn’t prevent ovarian failure in young women treated for lymphoma
MDedge Family Medicine
European Commission’s proposed criteria for endocrine disruptors trigger multiple concerns
MDedge Family Medicine
Power morcellation dropped, abdominal hysterectomy increased after FDA warning
MDedge Family Medicine
HIV infection linked with death from cervical cancer
MDedge Family Medicine
FDA, ACOG recommend against using ovarian cancer screening tests
MDedge Family Medicine
Recommendations for Cancer Moonshot overlook a few issues, YSC says
MDedge Family Medicine
Rise in HPV vaccination spurs CIN drop
MDedge Family Medicine
For HPV-negative women, longer screening intervals are effective
MDedge Family Medicine
Ovarian cancer screening update
MDedge Family Medicine