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Excess Pounds Boost
Risk of Cervical Cancer
Excerpt By Kathleen Doheny, HealthDay

Here's another reason for women carrying extra pounds to shed them -- being overweight doubles the risk of cervical cancer, a new study finds.

"Our study is not the first to look at obesity [and cervical cancer]," says James V. Lacey Jr., an epidemiologist at the National Cancer Institute and the lead author of the study, which appears in the Aug. 15 issue of Cancer.

"But by controlling for human papilloma virus [a sexually transmitted virus that causes genital warts and is considered the primary risk factor for cervical cancer], we got a better picture of what role obesity might also play. It showed us that when taking into account the role of HPV, obesity might be an important co-factor for cervical adenocarcinoma," Lacey says.

Cervical adenocarcinomas account for about 10 percent to 15 percent of all cervical cancers, he says.

Every year in the United States, about 15,000 women are diagnosed with cancer of the cervix, according to the National Cancer Institute, and most of those are squamous cell cancers. The cervix is the narrow, lower part of the womb, opening into the vagina.

In the study, Lacey and his team evaluated 124 women with adenocarcinoma, 139 with squamous cell cancer and 307 healthy controls, ranging in age from 18 to 69. The women gave their height and weight and researchers measured their waist-to-hip ratio, another measure of obesity.

Women with a Body Mass Index (BMI) above 30, which is considered obese, were 2.1 times more likely to have adenocarcinoma, compared with women who had BMIs in the healthy range, under 25. Less consistent results were found for squamous cell cancers, Lacey says.

A woman who is 5-foot-3 and weighs 135 pounds has a BMI of 24; if she weighs 170, her BMI is 30.

"Our study doesn't prove that obesity causes cervical cancer," Lacey says. "It confirms another reason to avoid obesity."

And, he says, the study also emphasizes the need to avoid being overweight. The link to cervical cancer was found "not just for obese women, but also for overweight women," he says.

Other risk factors for cervical cancer include intercourse before age 18, multiple sex partners, or a partner with many previous partners. A Pap test helps detect cervical cancers.

Exactly how excess weight may increase the risk of cervical cancer isn't known for sure. But it is thought that excess fat tissue can influence levels of estrogen and other sex hormones, and that, in turn, can increase susceptibility to cancers.

The new study strengthens the argument for the role of hormones in the development of some cancers, says another expert, Margaret M. Madeleine. She is an epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle, and is familiar with the new research.

"No other study has been able to tease out as clearly the association between BMI and cervical cancer by histologic [tissue] type," Madeleine says.

Dr. Jonathan Berek, chief of the division of gynecologic oncology at the University of California, Los Angeles' Jonsson Cancer Center, agrees, calling the new research "a good study."

A high BMI is already a known risk factor for endometrial cancers, so it's feasible that the same may hold true for cervical cancers, Berek says. Exactly how excess pounds can boost the risk isn't certain. But it might be that the higher levels of circulating estrogen in a heavy woman's body stimulate normal cells to become malignant cells, he says.

More information

To learn more about cervical cancer, visit the National Cancer Institute and the National Cervical Cancer Campaign.

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