Impact of metabolic syndrome on the risk of endometrial cancer and the role of lifestyle in prevention

Endometrial cancer (EC) is the second gynecological cancer with the highest global incidence. Among many associated risk factors, metabolic syndrome (MetS) is an important and preventable one. It comprises a group of conditions that often occur together: central adiposity, hyperglycemia, arterial hypertension, and atherogenic dyslipidemia. This review aimed to describe the epidemiological and biological relationship between MetS and EC, focusing on the role of lifestyle in prevention. A literature search was carried out in the PubMed database. 4824 publications were screened, and 123 were included for this review. The association between MetS and EC has been described. Chronic adipose tissue inflammation and insulin resistance are involved in the development of obesity, particularly visceral adiposity. These changes promote the ideal environment for the development of EC. Strategies based on lifestyle modifications may be effective for the prevention of MetS and consequently EC. Some of these modifications include adopting a diet rich in fruits, vegetables, whole grains, and legumes, depending to the accessibility of these foods for each region. Avoiding ultra-processed foods and increasing daily physical activity were also some suggested modifications. We propose that women be screened for MetS to establish early treatment and to possibly prevent EC. Clinical trials designed to prove the effect of lifestyle modifications on the prevention of EC are needed.