{"id":4283,"date":"2017-02-15T11:05:08","date_gmt":"2017-02-15T16:05:08","guid":{"rendered":"http:\/\/blogs.shu.edu\/cancer\/?p=4283"},"modified":"2021-07-02T08:51:43","modified_gmt":"2021-07-02T12:51:43","slug":"losing-10-pounds-or-more-confers-lower-risk-of-endometrial-cancer","status":"publish","type":"post","link":"http:\/\/blogs.shu.edu\/cancer\/2017\/02\/15\/losing-10-pounds-or-more-confers-lower-risk-of-endometrial-cancer\/","title":{"rendered":"Losing 10 pounds or more confers lower risk of endometrial cancer"},"content":{"rendered":"<p>The link between endometrial cancer and obesity is the <a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMsr1606602\" target=\"_blank\" rel=\"noopener\">strongest of all cancers studied<\/a>; obesity is also strongly linked to breast and colon cancer. In the Iowa Women\u2019s Health Study, \u00a0patients who intentionally lost at least 20 pounds demonstrated a risk of endometrial cancer <a href=\"http:\/\/www.nature.com\/ijo\/journal\/v27\/n12\/pdf\/0802437a.pdf?origin=publication_detail\" target=\"_blank\" rel=\"noopener\">equivalent to non-obese patients<\/a>. A supplemental analysis suggested that intentional loss of 10 pounds also reduced risk.<!--more--><\/p>\n<p>The <a href=\"http:\/\/ascopubs.org\/doi\/full\/10.1200\/JCO.2016.70.5822\" target=\"_blank\" rel=\"noopener\">Women\u2019s Health Initiative (WHI) included over 36,000 women<\/a>\u00a0who were followed for a mean of 11.4 years. Weight was evaluated prospectively over a three-year period; the primary endpoint was the development of endometrial cancer following the three-year study visit. Over the course of the study, 566 women developed endometrial cancer:<\/p>\n<p style=\"padding-left: 30px\"><em>After analyses were adjusted for baseline BMI and other potential confounders, women who had weight loss \u2265 5% had a significantly lower risk of endometrial cancer than women who had stable weight (HR, 0.71; 95% CI, 0.54 to 0.95). This was observed for any weight loss, but the risk was even lower for obese women who had intentional weight loss (HR, 0.44; 95% CI, 0.25 to 0.78).<\/em><em>\u00a0<\/em><\/p>\n<div id=\"attachment_4286\" style=\"width: 510px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/blogs.shu.edu\/cancer\/files\/2017\/02\/Table-1-Endometrial-cancer-and-weight-loss.gif\" data-rel=\"lightbox-image-0\" data-rl_title=\"\" data-rl_caption=\"\" title=\"\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4286\" class=\"size-full wp-image-4286\" src=\"http:\/\/blogs.shu.edu\/cancer\/files\/2017\/02\/Table-1-Endometrial-cancer-and-weight-loss.gif\" alt=\"\" width=\"500\" height=\"432\" \/><\/a><p id=\"caption-attachment-4286\" class=\"wp-caption-text\">Table 1. HRs (hazard ratio) and 95% CIs (confidence interval) for the Association Between Weight Change and Risk of Endometrial Cancer. <a href=\"http:\/\/ascopubs.org\/doi\/full\/10.1200\/JCO.2016.70.5822\" target=\"_blank\" rel=\"noopener\">http:\/\/ascopubs.org\/doi\/full\/10.1200\/JCO.2016.70.5822<\/a><\/p><\/div>\n<p style=\"padding-left: 30px\"><em>In a sensitivity analysis of weight loss and endometrial cancer subtypes, a stronger association was seen between intentional weight loss and risk of type I (<\/em><a href=\"http:\/\/ascopubs.org\/doi\/full\/10.1200\/jco.2012.48.2596\" target=\"_blank\" rel=\"noopener\">estrogen-dependent<\/a><em>) endometrial cancer compared with overall results (including type II tumors \u2013 serous and mixed cell). For example, compared with women who had stable weight (\u00b1 5%), women who had intentional weight loss had a 52% lower risk of type I endometrial cancer (HR, 0.48; 95% CI, 0.30 to 0.76) overall; obese women who had intentional weight loss had a 74% lower risk compared with obese women with stable weight (HR, 0.26; 95% CI, 0.12 to 0.57). Women who intentionally lost weight and had a normal BMI at 3 years (ie, &lt; 25 kg\/m<sup>2<\/sup>) had the same risk of endometrial cancer as women who maintained a stable normal BMI. <\/em><\/p>\n<p><em>\u00a0<\/em>Unintentional weight loss was NOT associated with reduced risk of endometrial cancer.<\/p>\n<p style=\"padding-left: 30px\"><em>To our knowledge, this study is the first to use measured baseline and follow-up weights with weight loss intentionality examined over a relatively short period to temporally link measured weight change in postmenopausal women. In this setting, modest weight loss was associated with a significantly lower risk of endometrial cancer. Additionally, although intentional weight loss was associated with a significantly lower risk of endometrial cancer, unintentional weight loss was not. <strong>These findings suggest that, in postmenopausal women, it may not be too late for weight loss to offer potential health benefits<\/strong>.<\/em><\/p>\n<p>We have previously discussed the <a href=\"http:\/\/blogs.shu.edu\/cancer\/2014\/09\/03\/obesity-soon-to-replace-tobacco-as-the-number-one-preventable-treatable-cause-of-cancer\/\" target=\"_blank\" rel=\"noopener\">link between obesity and cancer on this blog<\/a>. Briefly, there are three mechanisms by which obesity contributes to the development of cancer:<\/p>\n<ol>\n<li>Obese patients have increased levels of insulin and <a href=\"http:\/\/cancergrace.org\/lung\/2008\/08\/06\/igf-1r-for-squam-nsclc\/\" target=\"_blank\" rel=\"noopener\">IGF-1<\/a> (insulin-like growth factor 1), therefore, greater stimulation IGF-1R (insulin-like growth factor receptors), which drive cell growth and cell division;<\/li>\n<li>Adipocytes have direct and indirect effects on cellular <a href=\"http:\/\/www.nature.com\/nrc\/journal\/v9\/n8\/fig_tab\/nrc2676_F3.html\" target=\"_blank\" rel=\"noopener\">signaling molecules<\/a> (<strong>stimulation of mTOR<\/strong> \u2013 mammalian target of rapamycin, which is one of the terminal Akt\/PKB pathway effectors resulting in myc induction, and <strong>inhibition of AMP-activated protein kinase<\/strong> which blocks mTOR induction of myc);<\/li>\n<li>Obesity induces a chronic subacute level of inflammation, which promotes the development of cancer.<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The link between endometrial cancer and obesity is the strongest of all cancers studied; obesity is also strongly linked to breast and colon cancer. In the Iowa Women\u2019s Health Study, \u00a0patients who intentionally lost at least 20 pounds demonstrated a risk of endometrial cancer equivalent to non-obese patients. A supplemental analysis suggested that intentional loss [&hellip;]<\/p>\n","protected":false},"author":2252,"featured_media":3979,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[10,2,1],"tags":[408,403,1866,1867,1868],"class_list":["post-4283","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-prevention","category-statistics-epidemiology","category-uncategorized","tag-endometrial-cancer","tag-obesity-2","tag-weight-loss","tag-whi","tag-womens-health-initiative"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"http:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/posts\/4283","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/users\/2252"}],"replies":[{"embeddable":true,"href":"http:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/comments?post=4283"}],"version-history":[{"count":4,"href":"http:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/posts\/4283\/revisions"}],"predecessor-version":[{"id":4875,"href":"http:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/posts\/4283\/revisions\/4875"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/media\/3979"}],"wp:attachment":[{"href":"http:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/media?parent=4283"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/categories?post=4283"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/tags?post=4283"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}