Surge in endometrial cancer among younger women linked to rising obesity rates
Endometrial cancer, historically more prevalent in post-menopausal women, has seen a significant and concerning rise in cases among women under the age of 40. This trend has puzzled reproductive health experts, prompting urgent research into its causes.
Researchers from UCI Health now report a strong correlation between this surge in endometrial cancer among younger women and the rapidly increasing obesity rates. They argue that this trend demands immediate public health interventions to reverse the alarming trajectory.
Between 2001 and 2018, cases of endometrial adenocarcinoma—the most common form of endometrial cancer—rose by 137% among women aged 20 to 29, and by 71% among those aged 30 to 39, according to data presented at a recent American Society of Clinical Oncology (ASCO) conference. The increases were even more pronounced among younger Black women and Latinas.
Over the same period, obesity rates surged, rising by 7.5% per year among women aged 20 to 29, and by 4.5% annually among those aged 30 to 39, the study revealed.
A Public Health Emergency
“Endometrial cancer is the most common gynaecological cancer encountered in the United States,” notes Dr Krishnansu Tewari, a UCI Health gynaecologic oncologist and co-author of the study.
Once primarily seen in older women, endometrial adenocarcinoma is now the sixth most common cancer in women overall, and it is becoming increasingly deadly. It is projected to cause more than 13,000 deaths this year, up from 3,000 annual deaths in the late 1980s.
“This represents a public health emergency,” states Dr Alex Francoeur, the lead author of the study. Francoeur emphasises the need for a concerted effort to educate women and healthcare providers about the risks posed by obesity in developing endometrial adenocarcinoma.
Analysing Two Decades of Data
The retrospective study analysed data from more than 580,000 cases of endometrial adenocarcinoma in the U.S. over the last two decades. Researchers then compared these findings with data on obesity rates among women over the same period.
The results revealed a particularly strong link between rising obesity rates and increased incidences of cancer in younger women, especially women of colour.
“When examining trends by race and ethnicity, we found that the rate of endometrial cancer in Black women has increased by 25% since 2001, and by 17% in Hispanic women,” says Francoeur, who is a gynaecologic oncology fellow at the UCI School of Medicine’s Department of Obstetrics & Gynaecology.
Although further research is needed to establish a direct causal link, the study’s data strongly suggest the need for targeted public health initiatives aimed at educating women and reducing obesity rates.
Raising Awareness is Key
“Action is needed to address the impact of obesity on endometrial cancer,” Francoeur stresses. She advocates for the following measures:
- Raising awareness: “Sharing this information with gynaecology patients and providing early education on the risk factors associated with obesity and reproductive health is crucial.”
- Encouraging weight management: “Discussions about weight should become a routine part of health maintenance, similar to the way cervical cancer screenings and mammography are standard components of preventive care.”
Francoeur highlights that there are many ways for individuals to receive support, including consulting a dietitian, considering medications that target weight loss, and exploring surgical options to manage obesity.
Fertility-Sparing Treatment Options
For individuals of childbearing age diagnosed with endometrial cancer, surgery is not always the only treatment option.
“With early-stage endometrial cancers, we can often manage the disease with hormone therapy, allowing patients to preserve their ability to conceive,” explains Tewari, who is also a professor and chief of the Division of Gynaecologic Oncology in the Department of Obstetrics & Gynaecology.
Progestin therapy, a hormone treatment, can sometimes be used to shrink or eliminate the cancer temporarily in those wishing to maintain fertility. The most commonly used medications in this treatment are:
- Medroxyprogesterone acetate, administered as an injection or a pill.
- Megestrol acetate, available as a pill or liquid.
However, Tewari cautions that this approach is not yet a standard treatment and may increase the risk of cancer progression. “It’s vital to confirm the grade of the cancer with a gynaecologic oncologist and a pathologist, and to consult with a fertility specialist before beginning progestin therapy,” he advises.
