The Association Between Nutrition, Obesity, Inflammation, and Endometrial Cancer: A Scoping Review.

Abstract

Endometrial cancer is the most common gynecological malignancy and represents a notorious threat to women's health worldwide. Endometrial cancer predominantly affects post-menopausal women; yet the prevalence of this disease has been rising also among pre-menopausal women. Poor nutritional habits, inflammation, and obesity may be associated with endometrial cancer (EC) among both pre-menopausal and post-menopausal women and should be further assessed among a wide spectrum of age groups. This scoping review explores and reports on primary research studies conducted to investigate the impact of nutrition, inflammation, and/or obesity on endometrial cancer risk among both pre-menopausal and post-menopausal women. Using a predefined protocol in compliance with the PRISMA guidelines, a search was conducted on four separate databases including PubMed, Cochrane Library, ProQuest, and Google Scholar to investigate the association between nutrition, inflammation, obesity, and endometrial cancer. A total of 4862 articles were identified. Following a full article analysis, 27 articles met the full inclusion criteria and were included in the current review. Findings from the literature support a role of nutrition, obesity, and inflammation in the development of EC. The studies included in the current review supported that plant-based, Mediterranean, or ketogenic diets are associated with a lower risk of EC while there is no association between glycemic index and EC risk. On the other hand, increased BMI is associated with a higher risk of EC and there is a positive association between obesity-related pro-inflammatory biomarkers and increased risk for EC development. Further research needs to be conducted to gain more insight into the complex interactions between nutrition, obesity, and inflammation and their association with EC development among pre-, peri-, and post- menopausal women with the ultimate goal to improve management and preventive strategies and achieve reduced prevalence of endometrial cancer.