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Knowledge of Endometrial Cancer Risk Factors in a General Gynecologic Population

Obesity is a preventable condition that is associated with heart disease, diabetes, certain types of cancer, and innumerable other conditions causing significant morbidity and mortality in the United States. Despite that type 1 endometrial cancer (EC) was the first cancer to be associated with obesity, many women are unaware of the evidence-based association between obesity and EC. This educational gap could be associated with middle-aged survivors reporting lower physical activity levels compared with controls, the fact that two-thirds of patients gain weight after diagnosis, and the increasing incidence of type 1 EC in the United States that corresponds to an increasing rate of obesity. This questionnaire survey aimed to evaluate the knowledge of risk factors of EC among women presenting for routine gynecologic care at 2 general gynecologic practices. The questionnaire was administered to nonpregnant adults between August and October 2014. Patient demographic information and lifestyle information including dietary and activity levels, education level, and knowledge regarding the association between obesity and EC were obtained. Responses to the question of obesity affecting EC risk were based on a 5-level Likert scale ranging from “increases your risk a lot” to “decreases your risk a lot.”Questions regarding risk factors such as race, estrogen use, and age were also included, with all questions selected from a set of validated questions provided by the World Health Organization, Centers for Disease Control and Prevention, and Harvard Forums of Health Survey. A total of 231 women responded to the questionnaire with a median age of 56 years (interquartile range, 45–64 years) and a median body mass index (BMI) of 24.9 kg/m (interquartile range, 22.3–29.2 kg/m), and 87% of whom were White. The majority (68%) of women received a college or graduate degree, and this was more common among nonobese than obese women (P = 0.0044). More than half (52%) of all participants did not correctly identify that obesity was associated with increased risk of EC. Of these participants, 5% were normal weight, 24.8% were overweight, and 22.6% were obese. There were no differences in knowledge regarding the association of obesity and risk of EC between obese and nonobese women (47% vs 48%, P = 0.9275), respectively. Other factors measured including patient race, level of education, and income all had no association with ability to correctly identify obesity as a risk factor for EC. The majority (91%) of all participants reported that they had not had a discussion regarding the risk of EC with their gynecologist or primary care physician. Although not statistically significant, there was a trend in women who correctly stated that obesity increases risk of EC to be younger compared with those who reported not knowing or answered the question incorrectly. This study finds that more than half of women surveyed did not correctly identify that there is an association between increased risk of EC and obesity. These results highlight previous studies' findings and emphasize that there exists a need to further educate women regarding the association between health-related behaviors and risk of EC. 604 Obstetrical and Gynecological Survey Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.