Epidemiological Analysis of Obesity-related co-morbidities and mortality among post- menopausal women diagnosed with endometrial cancer: A Randomized Controlled Trial.

Objective Obesity is a risk factor for endometrial cancer (EC). Five-year survival is over 80%; however, mortality rates have increased in recent years. Post-menopausal women with EC frequently present with obesity-related comorbidities or develop comorbidities after diagnosis. Survival may vary related to this comorbidity burden. This analysis describes modifiable comorbidities (diabetes, cardiovascular disease, hypertension, and fractures) among post-menopausal EC survivors and evaluates the relationship between obesity-related comorbidities and mortality after an endometrial cancer diagnosis. Methods Epidemiological analysis of overall mortality in relation to incidence of obesity-related comorbidity (obesity, diabetes, cardiovascular disease, hypertension and fractures) after EC diagnosis. The participants are Post-menopausal women from 40 clinical sites across the U.S. participating in the Women’s Health Initiative (WHI) observational or clinical trials and diagnosed with incident EC during follow-up. Adjusted Cox proportional hazards regression models for incident EC were used to evaluate the relationship between comorbidities and all-cause mortality. Results 1661 incident cases of EC were identified. Mortality rates were 55.5% for women with EC. Prevalence increased from baseline to 18 y follow-up for each comorbidity. Regression analyses for incident EC indicated that severe obesity HR (95% CI): 2.13 (1.52, 2.97), cardiovascular disease, 1.50 (1.26, 1.78), and fracture, 1.17 (1.07, 1.27) were associated with greater overall mortality. Conclusions Obesity-associated comorbidities are common and are associated with greater mortality in post-menopausal women diagnosed with endometrial cancer. Interventions to modify risk for comorbidity in EC survivors may improve survival and should be evaluated. Clinical Trial Registration: NCT 00000611