The Role of Obesity in the Development and Management of Gynecologic Cancer

Importance: Endometrial cancer is the most common gynecologic malignancy, with an estimated 54,000 new cases and 10,000 deaths in the United States in 2015. The obesity epidemic directly contributes to the escalating prevalence of chronic diseases, including obesity-related cancers. Patient body weight and nutritional status markedly impact perioperative oncologic care, chemotherapy administration, recurrence risk, and survivorship goals. Objective: The objective of this review is to explore the association between obesity and the development, treatment, and survival outcomes of gynecologic cancers. Evidence Acquisition: A systematic literature review was performed utilizing PubMed and ClinicalTrials.gov. Conclusions and Relevance: Caring for obese women with gynecologic cancers presents unique challenges. A coordinated multidisciplinary and system effort is required to address the prevention and treatment of obesity, as the sequela of this disease is a clear risk factor for the development of gynecologic malignancy and other comorbidities. Health care providers must be ready to address this worldwide health problem. Target Audience: Obstetricians, gynecologists, family physicians, midwives, nurse practitioners, and dietitians Learning Objectives: After completion of this activity, the learner should be better able to describe the pathophysiologic correlation between obesity and common gynecologic malignancies; identify limitations in cancer care due to obesity and associated comorbidities; and counsel patients regarding management strategies for treatment of obesity.