Associated Trends in Obesity and Endometrioid Endometrial Cancer in the United States

Alex A Francoeur; Cheng-I Liao; Jenny Chang; Caitlin R Johnson; Kiran Clair; Krishnansu S Tewari; Daniel S Kapp; John K Chan; Robert E Bristow

doi:10.1097/AOG.0000000000005814

Associated Trends in Obesity and Endometrioid Endometrial Cancer in the United States

Obstet Gynecol. 2025 Jan 2. doi: 10.1097/AOG.0000000000005814. Online ahead of print.

Authors

Alex A Francoeur¹, Cheng-I Liao, Jenny Chang, Caitlin R Johnson, Kiran Clair, Krishnansu S Tewari, Daniel S Kapp, John K Chan, Robert E Bristow

Affiliation

¹ Department of Obstetrics and Gynecology and the Department of Medicine, University of California, Irvine, Orange, the Division of Gynecologic Oncology, California Pacific/Palo Alto/Sutter Health Research Institute, San Francisco, and the Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California; and the Department of Obstetrics and Gynecology, Pingtung Veterans Hospital, Pingtung City, Taiwan.

PMID: 39746203
DOI: 10.1097/AOG.0000000000005814

Abstract

Objective: To evaluate the correlation in temporal trends in obesity and endometrioid endometrial cancer incidence in the United States using two comprehensive national databases.

Methods: This is a cohort study in which data on endometrioid endometrial cancer were obtained from the U.S. Cancer Statistics from 2001 to 2018 and corrected for hysterectomy and pregnancy. Data on obesity were collected from the NHANES (National Health and Nutrition Examination Survey) database from 1988 to 2018. Average annual percentage changes (AAPCs) were used to describe trends. Pearson correlation coefficients (r) were calculated to examine the relationship between trends. SEER*Stat 8.3.9.2 and joinpoint regression program 5.2.0 were used for statistical analysis.

Results: From U.S. Cancer Statistics data, 586,742 cases of endometrioid cancer were identified from 2001 to 2018. The average annual increase in endometrioid cancer was as follows: Hispanic 1.37% (95% CI, 1.14-1.60, P<.001), Black 1.30% (95% CI, 1.04-1.57, P<.001), and White -0.17 (95% CI, -0.91 to 0.58, P=.656). Women aged 20-29 years had a 4.48% annual increase (95% CI, 3.72-5.25, P<.001) and women aged 30-39 years had a 3.00% annual increase in rates (95% CI, 2.65-3.36, P<.001). According to the NHANES data, the prevalence of obesity in 2018 in adult women was as follows: Black 56.80%, Hispanic 44.10%, and White 40.90%. An examination of trends by age showed that women aged 20-29 years had the highest annual rise in obesity compared with other age groups (AAPC 7.36%, 95% CI, 4.0-10.8, P<.05). Strong and statistically significant correlations between endometrioid cancer and obesity trends were noted for Black (r=0.78, P=.01) and Hispanic (r=0.91, P<.001) women, as well as women aged 20-29 years (r=0.72, P=.03) and 30-39 years (r=0.88, P=.001).

Conclusion: The current data demonstrate a temporal association between the increasing incidence of obesity and endometrioid endometrial cancer, and this effect disproportionately affects younger women and Black and Hispanic women.