Association of endometrial carcinoma with obesity and diabetes mellitus

Abstract

Background: Endometrial cancer, previously referred to as carcinoma of the uterus. The incidence of endometrial cancer is raising, due to improved screening causing fewer hysterectomies in ageing population. Several studies are going on to find out the association and effects between DM and DM-related diseases, especially the cancer. Obesity and physical inactivity plays important role as modifiable determinants of insulin resistance, hyperinsulinaemia and diabetes. All these factors are also responsible for endometrial cancer. Objectives: To find out the association between endometrial carcinoma with obesity and diabetes mellitus Methods: This was a cross sectional and observational study, conducted among. 50 consecutive patients admitted as known case of endometrial carcinoma diagnosed by fractional curettage and endometrial biopsy and 50 consecutive patients having other common gynaecological problems in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from January 2015 to December 2017. Results: Out of 50 women having endometrial carcinoma, only 4% (n=2) having healthy BMI, 36% (n=18) were overweight, 60% (n=30) were obese. Among 50 healthy women without endometrial carcinoma showed that 4% (n=2) having underweight, 70% (n=35) having healthy BMI, 14% (n=7) having overweight and only 12% (n=6) were obese. Regarding distribution of diabetes mellitus among study population, 50 women having endometrial carcinoma 26 % (n=13) were diabetic and 74% (n=37) were non diabetic.50 healthy women without endometrial carcinoma showed that 8% (n=4) diabetic and 92% (n=46) were non diabetic. Among total 17% (n=17) diabetic patients, 76.5% (n-13) having endometrial carcinoma and 23.5% (n=4) were healthy having no endometrial carcinoma. Among 83% (n=83) women having no diabetes 55.4% (n=46) were healthy having no endometrial carcinoma and 44.6% (n=37) having endometrial carcinoma. Association between Diabetes mellitus and endometrial carcinoma was statistically significant (p=0.017). Having high BMI (overweight, obese) and diabetics had significant elevated risks of endometrial cancer, compared with non-overweight non-diabetic subjects. Conclusion: Obesity, history of PCOS, physical inactivity and diabetes are the risk factors of endometrial carcinoma. So, it should be treated promptly these diseases to reduce risk factors. Moreover, strengthen public awareness to address these risk factors at earlier to reduce the cancer burden is recommended.