Obesity and female malignancies

Best Pract Res Clin Obstet Gynaecol. 2015 May;29(4):528-40. doi: 10.1016/j.bpobgyn.2015.01.003. Epub 2015 Feb 7.

Abstract

Obesity increases the risk of endometrial and ovarian cancer, and oestrogen receptor (ER)-progesterone receptor (PR)-positive postmenopausal breast cancer. A modest positive association between body mass index (BMI) and cervical cancer has also been found. By contrast, an inverse correlation between BMI and premenopausal breast cancer exists. Endogenous sex hormones, insulin resistance/hyperinsulinaemia, adipokines, cytokines and chronic inflammation, among other factors, may be involved in the promotion of cancer in obese patients. Obesity is also associated with an increased risk of cancer recurrence and mortality most likely due to suboptimal treatment and/or co-morbidities. It is recommended that chemotherapy doses be calculated on the actual body weight and that radical surgery be performed as in non-obese patients. The high risk of peri-operative complications may be reduced by optimizing preoperative clinical conditions. As part of cancer prevention, obese women should be encouraged to adopt healthy lifestyles leading to weight loss and to undergo regular cancer screening.

Keywords: breast cancer; cervical cancer; endometrial cancer; obesity; ovarian cancer; treatment.

MeSH terms

  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / therapy
  • Endometrial Neoplasms / epidemiology
  • Endometrial Neoplasms / metabolism
  • Endometrial Neoplasms / therapy
  • Estrogens / metabolism*
  • Female
  • Genital Neoplasms, Female / epidemiology
  • Genital Neoplasms, Female / metabolism*
  • Genital Neoplasms, Female / therapy
  • Humans
  • Neoplasms, Hormone-Dependent / metabolism
  • Obesity / epidemiology
  • Obesity / metabolism*
  • Ovarian Neoplasms / epidemiology
  • Ovarian Neoplasms / metabolism
  • Ovarian Neoplasms / therapy
  • Receptors, Estrogen / metabolism*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / metabolism
  • Uterine Cervical Neoplasms / therapy

Substances

  • Estrogens
  • Receptors, Estrogen