Weight-loss therapy in patients with obesity with endometrial intraepithelial neoplasia and uterine cancer

Affiliations

¹ Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA; Department of Gynecology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.
² Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
³ Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
⁴ Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA; Department of Medicine Columbia, University College of Physicians and Surgeons, New York, NY, USA.
⁵ Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA.
⁶ Department of Gynecology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.
⁷ Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁸ Department of Obstetrics and Gynecology at the Duke University Medical Center, Durham, NC, USA.
⁹ Department of Obstetrics, Gynecology, and Reproductive Science, and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹⁰ Herbold Computational Biology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
¹¹ Department of Medicine Columbia, University College of Physicians and Surgeons, New York, NY, USA.
¹² Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA. Electronic address: jw2459@columbia.edu.

PMID: 39163750
PMCID: PMC11560631 (available on 2025-11-01)
DOI: 10.1016/j.ygyno.2024.08.003

Weight-loss therapy in patients with obesity with endometrial intraepithelial neoplasia and uterine cancer

Yukio Suzuki et al. Gynecol Oncol. 2024 Nov.

. 2024 Nov:190:78-83.

doi: 10.1016/j.ygyno.2024.08.003. Epub 2024 Aug 22.

Authors

Affiliations

¹ Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA; Department of Gynecology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.
² Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
³ Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
⁴ Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA; Department of Medicine Columbia, University College of Physicians and Surgeons, New York, NY, USA.
⁵ Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA.
⁶ Department of Gynecology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.
⁷ Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁸ Department of Obstetrics and Gynecology at the Duke University Medical Center, Durham, NC, USA.
⁹ Department of Obstetrics, Gynecology, and Reproductive Science, and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹⁰ Herbold Computational Biology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
¹¹ Department of Medicine Columbia, University College of Physicians and Surgeons, New York, NY, USA.
¹² Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA. Electronic address: jw2459@columbia.edu.

PMID: 39163750
PMCID: PMC11560631 (available on 2025-11-01)
DOI: 10.1016/j.ygyno.2024.08.003

Abstract

Objective: Although obesity is an important risk factor for endometrial intraepithelial neoplasia (EIN) and uterine cancer, little is known about the trends in use of weight-loss therapy for patients with obesity with EIN and uterine cancer. We examined the use of weight-loss therapy among patients with obesity with EIN and uterine cancer.

Methods: The Merative MarketScan Database was used to identify patients aged 18-70 years who were obese and diagnosed with EIN or uterine cancer. The primary treatment for EIN or uterine cancer was categorized as either primary hysterectomy or hormonal therapy. Nutrition counseling, bariatric surgeries, and weight-management medications were identified as weight-loss therapy. We analyzed trends in the use of any weight-loss therapies with Cochran-Armitage tests. A multivariable logistic regression model was developed to examine factors associated with weight-loss therapy use.

Results: Overall, 15,374 patients were identified, including 5561 (36.2%) patients with EIN and obesity, and 9813 (63.8%) patients with uterine cancer and obesity. Weight-loss therapy was utilized within 1 year after diagnosis in 480 (8.6%) patients with EIN and in 802 (8.2%) patients with uterine cancer. Use of any weight-loss therapy after diagnosis of EIN increased from 4.1% in 2009 to 12.6% in 2020 (P < .001), and the use of any weight-loss therapy after diagnosis of uterine cancer increased from 4.9% in 2009 to 11.4% in 2020 (P < .001). In a multivariable regression model, younger age and patients with high comorbidity score were associated with a higher likelihood of using any weight-loss therapy.

Conclusions: Use of weight-loss therapy has increased, however there is still a significant underuse of this adjunctive therapy in patients with obesity with EIN or uterine cancer.

Keywords: Bariatric; Endometrial cancer; Endometrial hyperplasia; Endometrial intraepithelial neoplasia; Uterine cancer; Weight loss.

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Conflict of interest statement

Declaration of competing interest Dr. Wright has received royalties from UpToDate and the American College of Obstetricians and Gynecologistsand received research funding from Merck. All other authors declare no conflicts of interest. Dr. Suzuki reports receiving payment from The Japan Society for Menopause and Women's Health (JMWH Bayer Grant 2021), from Kanzawa Medical Research Foundation (Oversea Research Grant 2022), and from Mitsui & CO. (U.S.A), INC (Mitsui USA-JMSA Scholarship 2023). Dr. Elkin has received research support from Pfizer.

References

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Weight-loss therapy in patients with obesity with endometrial intraepithelial neoplasia and uterine cancer

Affiliations

Weight-loss therapy in patients with obesity with endometrial intraepithelial neoplasia and uterine cancer

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical