Higher Prediagnosis Body Mass Index Raises Mortality Risk in Endometrial Cancer

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Higher prediagnosis body mass index (BMI) increases risk of overall and disease-specific mortality among women diagnosed with endometrial cancer, suggested a study published in the Journal of the National Cancer Institute. Physical activity was associated with reduced risk of all-cause, but not disease-specific mortality.

The study examined associations of overall and endometrial cancer-specific 5- and 10-year mortality with prediagnosis BMI in 1,400 women and with physical activity in 875 women in the National Institutes of Health–AARP Diet and Health Study. “Compared with women with a BMI in the range of 18.5 to less than 25 kg/m2, the hazard ratios for 5-year all-cause mortality were 1.74 (95% confidence interval [CI] = 1.13–2.66) for BMI in the range of 25 to less than 30 kg/m2, 1.84 (95% CI = 1.17–2.88) for BMI in the range of 30 to less than 35 kg/m2, and 2.35 (95% CI = 1.48–3.73) for BMI greater than or equal to 35 kg/m2 (Ptrend < .001),” the investigators reported. Higher BMI was also statistically significantly associated with poorer endometrial cancer–specific mortality. The 5- and 10-year hazard ratio estimates for all-cause and endometrial cancer–specific mortality were similar at 10 years.

A baseline questionnaire was used to assess moderate-to-vigorous-intensity physical activities performed by study participants in the last 10 years. “Example activities included tennis, golf, biking, swimming, heavy gardening, fast walking or dancing, aerobics, and jogging,” the researchers reported.

“In adjusted models, prediagnosis [moderate-to-vigorous-intensity physical activities] was associated with a 43% lower risk of 5-year all-cause mortality in a comparison of never/rare exercisers to women who reported more than 7 hours of [moderate-to-vigorous-intensity physical activities] per week (hazard ratio [HR] = 0.57, 95% CI = 0.33–0.98),” the authors wrote. “After further adjustment for BMI, the association was attenuated (HR = 0.64, 95% CI = 0.37–1.12).”

The authors also noted that a joint effect analysis found that even among women who were not obese, those who were not physically active had an increased risk of 5-year mortality compared to their active counterparts.

The authors called for “intervention studies of the effect of these modifiable lifestyle factors.” ■

Arem H, et al: J Natl Cancer Inst 105:342-349, 2013.




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