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J Clin Oncol. 2017 Apr 10;35(11):1189-1193. doi: 10.1200/JCO.2016.70.5822. Epub 2017 Feb 6.

Intentional Weight Loss and Endometrial Cancer Risk.

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Juhua Luo and Michael Hendryx, Indiana University Bloomington, IN; Rowan T. Chlebowski, University of California, Los Angeles, Medical Center, Torrance; Marcia Stefanick, Stanford University School of Medicine, Stanford, CA; Thomas Rohan, Albert Einstein College of Medicine, Bronx; Jean Wactawski-Wende, University at Buffalo, SUNY, Buffalo, NY; Cynthia A. Thomson, The University of Arizona, Tucson, AZ; Ashley S. Felix, The Ohio State University, Columbus, OH; Chu Chen, Fred Hutchinson Cancer Research Center; Wendy Barrington, University of Washington, Seattle, WA; Mace Coday, University of Tennessee Health Science Center, Memphis, TN; Erin LeBlanc, Kaiser Permanente Center for Health Research, Portland, OR; and Karen L. Margolis, Health Partners Institute, Minneapolis, MN.


Purpose Although obesity is an established endometrial cancer risk factor, information about the influence of weight loss on endometrial cancer risk in postmenopausal women is limited. Therefore, we evaluated associations among weight change by intentionality with endometrial cancer in the Women's Health Initiative (WHI) observational study. Patients and Methods Postmenopausal women (N = 36,794) ages 50 to 79 years at WHI enrollment had their body weights measured and body mass indices calculated at baseline and at year 3. Weight change during that period was categorized as follows: stable (change within ± 5%), loss (change ≥ 5%), and gain (change ≥ 5%). Weight loss intentionality was assessed via self-report at year 3; change was characterized as intentional or unintentional. During the subsequent 11.4 years (mean) of follow-up, 566 incident endometrial cancer occurrences were confirmed by medical record review. Multivariable Cox proportional hazards regression models were used to evaluate relationships (hazard ratios [HRs] and 95% CIs) between weight change and endometrial cancer incidence. Results In multivariable analyses, compared with women who had stable weight (± 5%), women with weight loss had a significantly lower endometrial cancer risk (HR, 0.71; 95% CI, 0.54 to 0.95). The association was strongest among obese women with intentional weight loss (HR, 0.44; 95% CI, 0.25 to 0.78). Weight gain (≥ 10 pounds) was associated with a higher endometrial cancer risk than was stable weight, especially among women who had never used hormones. Conclusion Intentional weight loss in postmenopausal women is associated with a lower endometrial cancer risk, especially among women with obesity. These findings should motivate programs for weight loss in obese postmenopausal women.

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