Bariatric Surgery, Lifestyle Interventions May Cut Endometrial Cancer Risk by 44 Percent: Study Finds

The study, led by Matheus de L Ruffini and his team from Universidade Federal do Rio Grande do Sul (UFRGS) in Brazil, synthesized evidence from over 8.9 million individuals, emphasizing weight reduction as a promising preventive measure against this common gynecological malignancy. 

Endometrial cancer, which predominantly affects postmenopausal women, has long been associated with obesity. However, until now, the precise benefits of intentional weight loss in reducing EC risk have not been well quantified. The researchers addressed this gap by evaluating lifestyle-driven and surgical weight loss interventions. 

The study involved a meticulous literature review, using multiple scientific databases such as Embase, PubMed, Web of Science, LILACS, and Scielo. Applying a patient-intervention-comparison-outcome (PICO) framework, the researchers screened nearly 800 articles. Ultimately, 12 studies met the inclusion criteria. These studies focused on women aged 18 years or older, all with a body mass index (BMI) of 30 or higher and no prior history of endometrial cancer.

The review analyzed data from 307,020 women who had undergone intentional weight loss and compared their outcomes with over 8.6 million women in the control group.

Key Findings:

• Individuals who lost weight showed a 44% reduction in the risk of developing endometrial cancer.
• A hazard ratio of 0.56 was observed in five pooled studies, indicating a significant decrease in risk.
• Studies focusing on bariatric surgery reported an even stronger protective effect, with an odds ratio of 0.46.

Although the included studies did not consistently differentiate between types of endometrial cancer, the authors suggest that the reduced risk likely pertains primarily to type 1 endometrial cancer, which is more strongly associated with obesity-related hormonal imbalances.

Despite the promising findings, the authors noted variability across the included studies in terms of design and intervention clarity, which may introduce potential biases. They emphasized the importance of future research that includes modern weight loss methods, such as pharmacological treatments, and more precisely categorizes cancer subtypes.

“The meta-analysis reinforces the role of intentional weight loss as a viable strategy to prevent endometrial cancer in obese women. While bariatric surgery demonstrates the most significant impact, lifestyle interventions also provide meaningful benefits,” the authors stated. They further emphasized that the study highlights the need for continued research to strengthen clinical guidelines and broaden preventive strategies for at-risk populations.

Reference:

Ruffini, L., Fraga, B. L., G. Moraes, E. A., F. Ribeiro, H. G., C. Sei, L. J., Hartmann, M. L., Matos, M. R., L. Lopes, R. I., Júnior, S. C., F. Toledo, S. A., & Pessini, S. A. Weight loss measures and their impact on the risk of developing endometrial cancer: A systematic review and meta-analysis. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.70219