Obezitenin kadın kanserleri üzerindeki etkileri: derleme makalesi

Özet: Bu araştırmayı yapma amacımız; kanser gelişiminde önemli oranda rol oynayan ama genellikle ihmal edilen obezite ile kadın genital sistem kanserleri arasındaki ilişkiyi araştırmak ve bu soruna karşı güncel bilgiler ışığında farkındalık oluşturmaktır. Ancak, obezitenin yol açtığı ciddi sağlık problemleri arasında yer alan kanserler, diyabet, hipertansiyon, kardiyovasküler hastalıklar ve kronik obstrüktif akciğer hastalıkları gibi sorunların gölgesinde kalmıştır. Genel olarak, kanserlerin %20’sinin obezite ile ilişkisi bulunmakta ve obez kadınların yaklaşık %15-30 civarında kilo vermesi ile kanser riski önemli oranda azalmaktadır. Konuyu jinekolojik kanserler açısından değerlendirdiğimizde, endometriyum kanserinin obezite ile ilişkisi net olarak ortaya çıkarılmıştır. Ayrıca, meme kanserleri ve epitelyal tipte over kanserlerinin obezite ile ilişkisinin olduğu bilinmektedir. Son yıllarda yapılan çalışmalar, serviks kanserlerinin de obezite ile bağlantısının olduğunu göstermeye başlamıştır. Obezite, kadınlarda erkeklere göre daha yüksek oranda görülen ve günümüzde hızla artan genel bir sağlık problemidir. Ayrıca menapoz sonrası ortaya çıkan hormonal değişiklikler, kadın sağlığı üzerinde olumsuz etkiler meydana getirmektedir. Sonuç olarak obezite, kanser ve diğer kronik hastalıkların gelişimi açısından önlenebilir bir risk faktörü olup, yapılacak olan etkili mücadele sayesinde kanser insidansı önemli oranda düşürülebilir ve her 5 kanser ölümünden biri engellenebilir. Abstract: Our aim in conducting this study is to investigate the relationship between obesity and female genital system cancers, which play a significant role in carcinogenesis but is usually neglected and to create awareness against this issue in the light of current information. However, cancers, which are among the serious health problems caused by obesity, have been overshadowed by problems such as diabetes, hypertension, cardiovascular diseases and chronic obstructive lung diseases. 20% of cancers are generally associated with obesity, and the risk of cancer decreases considerably with obese women’s losing weight about 15-30%. When we evaluate the subject in terms of gynaecological cancers, the relationship between endometrial cancer and obesity was clearly revealed. It is also known that breast cancers and ovarian cancers of the epithelial type have a relationship with obesity. Recent studies have begun to show that cervical cancers are associated with obesity. Obesity is a general health problem that is seen at a higher rate in women than men and is increasing rapidly today. Moreover, it creates negative effects on women health changes emerging after menopause. As a result, obesity is a preventable risk factor for the development of cancer and other chronic diseases and the incidence of cancer can be significantly reduced and one in every 5 cancer deaths can be prevented thanks to the effective struggle
Anahtar Kelimeler:

Obezite, fazla kilolu kadınlar

Effects of obesity on female cancers: review article

Özet: Bu araştırmayı yapma amacımız; kanser gelişiminde önemli oranda rol oynayan ama genellikle ihmal edilen obezite ile kadın genital sistem kanserleri arasındaki ilişkiyi araştırmak ve bu soruna karşı güncel bilgiler ışığında farkındalık oluşturmaktır. Ancak, obezitenin yol açtığı ciddi sağlık problemleri arasında yer alan kanserler, diyabet, hipertansiyon, kardiyovasküler hastalıklar ve kronik obstrüktif akciğer hastalıkları gibi sorunların gölgesinde kalmıştır. Genel olarak, kanserlerin %20’sinin obezite ile ilişkisi bulunmakta ve obez kadınların yaklaşık %15-30 civarında kilo vermesi ile kanser riski önemli oranda azalmaktadır. Konuyu jinekolojik kanserler açısından değerlendirdiğimizde, endometriyum kanserinin obezite ile ilişkisi net olarak ortaya çıkarılmıştır. Ayrıca, meme kanserleri ve epitelyal tipte over kanserlerinin obezite ile ilişkisinin olduğu bilinmektedir. Son yıllarda yapılan çalışmalar, serviks kanserlerinin de obezite ile bağlantısının olduğunu göstermeye başlamıştır. Obezite, kadınlarda erkeklere göre daha yüksek oranda görülen ve günümüzde hızla artan genel bir sağlık problemidir. Ayrıca menapoz sonrası ortaya çıkan hormonal değişiklikler, kadın sağlığı üzerinde olumsuz etkiler meydana getirmektedir. Sonuç olarak obezite, kanser ve diğer kronik hastalıkların gelişimi açısından önlenebilir bir risk faktörü olup, yapılacak olan etkili mücadele sayesinde kanser insidansı önemli oranda düşürülebilir ve her 5 kanser ölümünden biri engellenebilir. Abstract: Our aim in conducting this study is to investigate the relationship between obesity and female genital system cancers, which play a significant role in carcinogenesis but is usually neglected and to create awareness against this issue in the light of current information. However, cancers, which are among the serious health problems caused by obesity, have been overshadowed by problems such as diabetes, hypertension, cardiovascular diseases and chronic obstructive lung diseases. 20% of cancers are generally associated with obesity, and the risk of cancer decreases considerably with obese women’s losing weight about 15-30%. When we evaluate the subject in terms of gynaecological cancers, the relationship between endometrial cancer and obesity was clearly revealed. It is also known that breast cancers and ovarian cancers of the epithelial type have a relationship with obesity. Recent studies have begun to show that cervical cancers are associated with obesity. Obesity is a general health problem that is seen at a higher rate in women than men and is increasing rapidly today. Moreover, it creates negative effects on women health changes emerging after menopause. As a result, obesity is a preventable risk factor for the development of cancer and other chronic diseases and the incidence of cancer can be significantly reduced and one in every 5 cancer deaths can be prevented thanks to the effective struggle.

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  • 1. Wolin KY, Carson K, Colditz GA. Obesity and cancer. Oncologist 2010;15:556-65.
  • 2. Birks S, Peeters A, Backholer K, et al. A systematic review of the impact of weight loss on cancer incidence and mortality. Obez Rev 2012;13:868-91.
  • 3.World Health Organization. Obesity and overweight. 2011.http://www.who.int/media centre/factsheets/fs311/en/index. html.
  • 4. Ostor, A.G., Adam, R., Gutteridge, B.H. et al. (Endometrial carcinoma in young women. N. Z. J. Obstet. Gynecol 1982;22:38–40.
  • 5. Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 2014;20:748-58.
  • 6. Cuzick J, Sestak I, Baum M, et al. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer:10-year analysis of the ATAC trial. Lancet Oncol 2010;11:1135-41.
  • 7. Kozan O, Oguz A, Abaci A, et al. Prevalence of the metabolic syndrome among Turkish adults. (METSAR). Eur J Clin Nutr 2007; 61: 548-553.
  • 8. Esposito K, Chiodini P, Capuano A, Bellastella G, Maiorino MI, GiuglianoD. Metabolic syndrome and endometrial cancer: a meta-analysis. Endocrine 2014; 45:28-36. DOI 10.1007/s12020-013-9973-3.
  • 9. Wiseman M. The second World Cancer Research Fund/American Institute for Cancer Research expert report. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Proc Nutr Soc 2008;67:253-6.
  • 10. Ward KK, Roncancio AM, Shah NR, DavisMA, Saenz CC, McHale MT, et al. The risk of uterine malignancy is linearly associated with body mass index in a cohort of US women. Am J Obstet Gynecol 2013;209:579.
  • 11. Yang TY, Cairns BJ, Allen N, Sweetland S, Reeves GK, Beral V. Postmenopausal endometrial cancer risk and body size in early life and middle age: prospective cohort study. Br J Cancer 2012;107:169–75.
  • 12. Jeong NH, Lee JM, Lee JK, Kim JW, Cho CH, KimSM, et al. Role of body mass index as a risk and prognostic factor of endometrioid uterine cancer in Korean women. Gynecol Oncol 2010;24–8.
  • 13. World Cancer Research Fund / American Institute for Cancer Research. Continuous Update Project Report. Food, Nutrition, Physical Activity, and the Prevention of Endometrial Cancer. 2013.
  • 14. Everett E, Tamimi H, Greer B, et al. The effect of body mass index on clinical/pathologic features, surgical morbidity, and outcome in patients with endometrial cancer. Gynecol Oncol 2003;90:150–7.
  • 15. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003;348:1625–38.
  • 16. Arem H, Park Y, Pelser C, et al. Prediagnosis body mass index, physical activity, and mortality in endometrial cancer patients. J Natl Cancer Inst. 2013;105: 342-349.
  • 17. Gunderson CC, Java J, Moore KN, et al. The impact of obesity on surgical staging, complications, and survival with uterine cancer: a Gynecologic Oncology Group LAP2 ancillary data study. Gynecol Oncol 2014;133:23-7.
  • 18. Reeves KW, Carter GC, Rodabough RJ, et al. Obesity in relation to endometrial cancer risk and disease characteristics in the Women's Health Initiative. Gynecol Oncol 2011;121:376-382.
  • 19. Ward KK, Roncancio AM, Shah NR, Davis MA, Saenz CC, McHale MT, Plaxe SC. Bariatric surgery decreases the risk of uterine malignancy. Gynecologic Oncology 2014; 133:63–66.
  • 20. Vargas AN. Natural history of ovarian cancer. Ecancermedicalscience 2014; 8: 465.
  • 21. Jemal A, Siegel R, Murray T, Hao Y, Xu J, Murray T, et al. Cancer statistics, 2009. CA Cancer J Clin 2009; published online. doi:10.3322/caac.20006.
  • 22. Scully RE, Young RH, Clement PB. Tumors of the ovary, maldeveloped gonads, fallopian tube, and broad ligament. In: Atlas of tumor pathology, 3rd Series, Fascicle 23. Washington, DC: Armed Forces Institute of Pathology, 1998:1-168.
  • 23. Feng YH. The association between obesity and gynecological cancer. Gynecology and Minimally Invasive Therapy xxx (2015) 1e4. http://dx.doi.org/10.1016/j.gmit.2015.03.003. (Article in press).
  • 24. Engeland A, Tretli S, Bjorge T. Height, body mass index, and ovarian cancer: a follow-up of 1.1 million Norwegian women. J Natl Cancer Inst 2003;95:1244-1248.
  • 25. Olsen CM, Green AC,Whiteman DC, et al. Obesity and the risk of epithelial ovarian cancer: a systematic review and metaanalysis. Eur J Cancer 2007;43:690-709.
  • 26. Ose J, Fortner RT, Rinaldi S, et al. Endogenous androgens and risk of epithelial invasive ovarian cancer by tumor characteristics in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer 2015;136:399-410.
  • 27. Olsen CM, Nagle CM,Whiteman DC, et al. Obesity and risk of ovarian cancer subtypes: evidence from the Ovarian Cancer Association Consortium. Endocr Relat Cancer 2013;20:251-62.
  • 28. Protani MM, Nagle CM, Webb PM. Obesity and ovarian cancer survival: a systematic review and meta-analysis. Cancer Prev Res (Phila) 2012;5:901-10.
  • 29. Yang HS, Yoon C, Myung SK, et al. Effect of obesity on survival of women with epithelial ovarian cancer: a systematic review and meta-analysis of observational studies. Int J Gynecol Cancer 2011;21:1525-32.
  • 30. Bae HS, Kim HJ, Hong JH, et al. Obesity and epithelial ovarian cancer survival: a systematic review and meta-analysis. J Ovarian Res 2014;7:41.
  • 31. World Health Organization. Globocan 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012.http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx.
  • 32. Santen RJ. Breast Cancer. In:” Yen and Jaffe’s Reproductive Endocrinology”, Ch 27, pp 659-686, Saunders Elsevier, 6th Ed, Philadelphia.
  • 33. Kruper L, Giuliano AE. Breast disease. In: “Berek & Hacker’s Gynecologic Oncology, Ch 16, pp 614-653, 5th Ed, Lippincott Williams & Wilkins.
  • 34. Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ 2007;335:1134.
  • 35. Lahmann PH, Lissner L, Gullberg B, et al. A prospective study of adiposity and postmenopausal breast cancer risk: the Malmo Diet and Cancer Study. Int J Cancer 2003;103:246-52. 36. James FR, Wootton S, Jackson A, Wiseman M, Copson ER, Cutress RI. Obesity in breast cancer – What is the risk factor? European Journal of Cancer 2015; 51: 705–720
  • 37. AICR / WCRF. Continuous Update Project – breast cancer 2010 report. 2011.
  • 38. AICR / WCRF. Second Expert Report - Food, Nutrition, Physical Activity, and the Prevention of Cancer: a global perspective. 2012, World Cancer Research Foundation.
  • 39. Bhaskaran K, Douglas I, Forbes H, et al. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5.24 million UK adults. Lancet 2014;384:755-65.
  • 40. Cheraghi Z, Poorolajal J, Hashem T, et al. Effect of body mass index on breast cancer during premenopausal and postmenopausal periods: a meta-analysis. PLoS One 2012;7:e51446.
  • 41. Munsell MF, Sprague BL, Berry DA, et al. Body mass index and breast cancer risk according to postmenopausal estrogenprogestin use and hormone receptor status. Epidemiol Rev 2014;36:114-36.
  • 42. Santen RJ. Breast Cancer. In:” Yen and Jaffe’s Reproductive Endocrinology”, Ch 27, pp 659-686, Saunders Elsevier, 6th Ed, Philadelphia, 2009.
  • 43. American Cancer Society. http://www. cancer.org /research/ cancerfactsstatistics / cancerfactsfigures2012/.
  • 44. John EM, Sangaramoorthy M, Phipps AI, Koo J, Horn-Ross PL. Adult body size, hormone receptor status, and premenopausal breast cancer risk in a multiethnic population: the San Francisco Bay Area breast cancer study. Am J Epidemiol 2011;173:201-216.
  • 45. Lahmann PH, Hoffmann K, Allen N, et al. Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer And Nutrition (EPIC). Int J Cancer. 2004;111:762-771.
  • 46. Harvie M, Hooper L, Howell AH. Central obesity and breast cancer risk: a systematic review. Obes Rev 2003;4:157–73.
  • 47. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 2008;371:569-78.
  • 48. Cleary MP, Grossmann ME. Minireview: obesity and breast cancer: the estrogen connection. Endocrinology 2009;150:2537-42.
  • 49. Chlebowski RT, Aiello E, McTiernan A. Weight loss in breast cancer patient management. J Clin Oncol. 2002;20:1128-1143.
  • 50. Chan DS, Vieira AR, Aune D, et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol 2014;25:1901-14.
  • 51. Protani M, Coory M, Martin JH. Effect of obesity on survival of women with breast cancer: systematic review and metaanalysis. Breast Cancer Res Treat 2010;123:627-35.
  • 52. Dal Maso L et al. Effect of obesity and other lifestyle factors on mortality in women with breast cancer. Int J Cancer 2008;123(9):2188–94.
  • 53. Goodwin, P. Obesity, insulin resistance and breast cancer outcomes. http://dx.doi.org/10.1016/j.breast.2015.07.014 0960-9776/© 2015 Published by Elsevier Ltd.
  • 54. Pan H, Gray RR, on behalf of the Early Breast Cancer Trialists' Collaborative Group. Effect of obesity in premenopausal ERþ early breast cancer: EBCTCG data on 80,000 patients in 70 trials. J Clin Oncol 2014;32(15 Suppl.):503.
  • 55. Pierobon M, Frankenfeld CL. Obesity as a risk factor for triple-negative breast cancers: a systematic review and meta-analysis. Breast Cancer Res Treat.2013;137:307e314.
  • 56. Bradshaw PT, Ibrahim JG, Stevens J, et al. Postdiagnosis change in bodyweight and survival after breast cancer diagnosis.Epidemiology 2012;23:320-7.
  • 57. Chlebowski RT, Blackburn GL, Thomson CA, et al. Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women's Intervention Nutrition Study. J Natl Cancer Inst 2006;98:1767-76.
  • 58. Maruthur NM, Bolen SD, Brancati FL, Clark JM. The association of obesity and cervical cancer screening: a systematic review and meta-analysis. Obesity (Silver Spring) 2009;17:375-381.
  • 59. Lacey Jr JV, Swanson CA, Brinton LA, et al. Obesity as a potential risk factor for adenocarcinomas and squamous cell carcinomas of the uterine cervix. Cancer 2003;98:814e21.
  • 60. Frumovitz M, Jhingran A, Soliman PT, et al. Morbid obesity as an independent risk factor for disease-specific mortality in women with cervical cancer. Obstet Gynecol 2014;124:1098-104.