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International Journal of Obesity (2013) 37, 634639 & 2013 Macmillan Publishers Limited All rights reserved 0307-0565/13
http://www.nature.com/IJO
Web End =www.nature.com/ijo
REVIEW
Obesity and endometrial cancer survival: a systematic review
H Arem and ML Irwin
Although it is known that obesity increases the risk of endometrial cancer and is linked to higher mortality rates in the general population, the association between obesity and mortality among endometrial cancer survivors is unclear. We performed a medline search using exploded Mesh keywords endometrial neoplasms/ and (body mass index/ or obesity/) and (survival analysis/or mortality/ or (survivor* or survival*).mp.). We also inspected bibliographies of relevant papers to identify related publications. Our search criteria yielded 74 studies, 12 of which met inclusion criteria. Four of the included studies reported a statistically or marginally signicant association between obesity and higher all cause mortality among endometrial cancer survivors after multivariate adjustment. The suggestive association between body mass index and higher all cause mortality among women with endometrial cancer was comparable to the magnitude of association reported in prospective studies of healthy women. Of the ve studies that examined progression-free survival and the two studies reporting on disease-specic mortality, none reported an association with obesity. Future studies are needed to understand disease-specic mortality, the importance of obesity-onset timing and whether mechanisms of obesity-related mortality in this population of women differ from those of the general population.
International Journal of Obesity (2013) 37, 634639; doi:http://dx.doi.org/10.1038/ijo.2012.94
Web End =10.1038/ijo.2012.94 ; published online 19 June 2012
Keywords: endometrial neoplasms; survivorship; mortality; body mass index
INTRODUCTIONIt is estimated that in the United States 47 130 women will be diagnosed with endometrial (uterine corpus) cancer in 2012, making it the fourth most common incident cancer among women.1 An estimated 8120 deaths from endometrial cancer were expected in 2011, making it the second most common cause of gynecologic cancer death.2 Uterine cancer is a broad term that encompasses all cancers that develop in the uterus, the most common of which is endometrial cancer, or cancers arising in the lining of the uterus.1 Previous publications show that parity, body mass index (BMI), physical activity and diet may explain up to 80% of the risk of endometrial cancer.3 Most (8090%) endometrial cancers are type 1(ref. 4) and are normally hormone sensitive, early