A claim you hear on longevity podcasts

Does obesity raise endometrial cancer risk?

Strong consensus for. Of 10 studies that test it, 10 agree.

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Women with obesity who want to know their risk of endometrial cancer
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The claim checked: Obesity is, almost with certainty, a risk factor for endometrial cancer Hear it at 4:13

What do the studies say?

Strong consensus for

All ten studies agree. Endometrial cancer is cancer of the lining of the womb. In UK adults, each 5-point rise in BMI went with a large rise in the risk of cancer of the womb. In 33,436 women past menopause, those with a BMI of 35 or more had 4.70 times the risk of women at a healthy weight. One study of UK women estimated that about half of these cancers after menopause come from overweight or obesity. Genetic studies, which help rule out other causes, point the same way.

Computed from 10 studies that test this point, each judged by two readers, in full. 10 more studies are waiting for a full read and do not count yet.

What was said on the podcast?

“We know almost with great certainty that obesity is a risk factor for certain kinds of cancers, endometrial being one of them.”
Siddhartha Mukherjee, a guest on The Drive · 412 ‒ The evolving science of cancer: emerging approaches to prevention and early detection, & more · 4:13 on YouTube
Episode check Cancer blood tests for everyone won't cut deaths, the episode says. Ten studies are mixed on it. 6 claims checked against 87 studies · 17 chapters not checked yet See the whole episode →
The point checked Strong consensus for

Obesity raises the risk of endometrial cancer

Agree 10

other primary study · 2014 · landmark

“With BMI included as a linear effect, and adjusting for all potential confounders, each 5 kg/m 2 increase in BMI was associated with a large increase in risk of cancer of the uterus (HR 1·62, 99% CI 1·56–1·69; figure 2 ).”

Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults. Lancet
Who: UK adults aged 16 or older with BMI recorded in the Clinical Practice Research Datalink primary care records, no prior cancer
PMID 25129328

trial or observed group · 2007 · landmark

“For endometrial cancer and adenocarcinoma of the oesophagus, body mass index represents a major modifiable risk factor; about half of all cases in postmenopausal women are attributable to overweight or obesity.”

Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ
Who: UK women aged 50-64 recruited through NHS breast screening in 1996-2001 (Million Women Study); endometrial analyses limited to women without hysterectomy
PMID 17986716

trial or observed group · 2013 · landmark

“The OR per 2 kg/m2 increase in BMI was 1.12 (95% CI, 1.09 to 1.14) for type II tumors, weaker than that for type I tumors (OR = 1.20; 95% CI, 1.19 to 1.21; Pheterogeneity < .0001).”

Type I and II endometrial cancers: have they different risk factors? J Clin Oncol
Who: Women in 10 cohort and 14 case-control studies of the Epidemiology of Endometrial Cancer Consortium (pooled individual-level data)
PMID 23733771

systematic review · 2017 · landmark

“Most of the associations between adiposity indices and endometrial cancer were supported by strong or highly suggestive evidence.”

Adiposity and cancer at major anatomical sites: umbrella review of the literature. BMJ
Who: Systematic reviews and meta-analyses of observational studies of adiposity and cancer incidence or mortality
PMID 28246088

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pooled analysis · 2015

“In summary, this meta analysis confirms a positive association between body fatness, weight gain and height and endometrial cancer risk.”

Anthropometric factors and endometrial cancer risk: a systematic review and dose-response meta-analysis of prospective studies. Ann Oncol
Who: Prospective studies of anthropometric factors and endometrial cancer risk (WCRF Continuous Update Project)
PMID 25791635

trial or observed group · 2010

“An OR of 2.02 (95% CI: 1.26–3.23, P trend =0.005) was observed for obese women (BMI ≥30 kg/m 2 ) compared to normal weight women (BMI <25 kg/m 2 ; Table 5 ).”

Obesity, inflammatory markers, and endometrial cancer risk: a prospective case-control study. Endocr Relat Cancer
Who: Women in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, nested case-control study
PMID 20843938

pooled analysis · 2017

“One of the most prominent associations identified in the current umbrella review was that between obesity and risk of endometrial cancer, for which two meta-analyses met the criteria for strong and nine for highly suggestive evidence.”

Obesity and gynaecological and obstetric conditions: umbrella review of the literature. BMJ
Who: Systematic reviews and meta-analyses of adiposity and obstetric or gynaecological outcomes
PMID 29074629

trial or observed group · 2008

“In multivariate analysis, BMI at baseline was strongly related to endometrial cancer incidence (BMI, 35.0+; RR, 4.70; 95% CI, 3.12-7.07 versus BMI, 22.5-25.0, P < 0.0001; Table 2).”

Body mass and endometrial cancer risk by hormone replacement therapy and cancer subtype. Cancer Epidemiol Biomarkers Prev
Who: 33,436 postmenopausal women with an intact uterus in the Cancer Prevention Study II Nutrition Cohort (US, aged 50-74 at enrollment), excluding estrogen-only hormone users
PMID 18187388

other primary study · 2020

“Compared with those of normal weight, individuals with obesity had positive associations for 10 cancers: endometrium, biliary tract, kidney pancreas, oesophagus, liver, bladder, postmenopausal breast and colorectal cancers and multiple myeloma.”

Association of obesity status and metabolic syndrome with site-specific cancers: a population-based cohort study. Br J Cancer
Who: 390,575 UK Biobank adults aged 40-69 without cancer at baseline (53% women); endometrial models excluded women with prior hysterectomy
PMID 32728095

pooled analysis · 2022

“We show that lifelong elevated BMI causes a larger increased risk than that reported in previous conventional observational studies.”

Identifying molecular mediators of the relationship between body mass index and endometrial cancer risk: a Mendelian randomization analysis. BMC Med
Who: women of European ancestry in a meta-GWAS of 17 studies (ECAC, E2C2, UK Biobank) from Australia, Belgium, Germany, Poland, Sweden, the UK and the USA; BMI instrument from a GWAS of 681,275 Europeans
PMID 35436960

Partly agree 0· none of the studies we read

Disagree 0· none of the studies we read

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