The University of North Carolina at Chapel Hill, Chapel Hill, NC
Leslie Horn Clark , Emily Meichun Ko , Amber Kernodle , Ariel Harris , Dominic T. Moore , Paola A. Gehrig , Victoria Lin Bae-Jump
Background: Obesity is a well-established risk factor for development of endometrial cancer (EC); it has been linked to decreased survival, worse surgical outcomes, and poor quality of life in EC patients. We sought to assess EC survivor’s awareness of obesity and its role in EC. Methods: Following IRB approval, women diagnosed with EC from 2011 – 2012 were identified. Patients with persistent/recurrent disease or those actively undergoing treatment were excluded. A pre-survey invitation to participate was sent 1 week prior to the survey. Surveys were mailed to 233 women. Reminder postcards were sent 2 weeks following the survey. Demographics, weight and weight assessment, patient’s health behaviors, and information regarding physician counseling was collected. Along with descriptive statistics, the kappa statistic was reported as a measure of agreement. Results: Of 233 surveys sent, 46% (n=108) were returned. The median BMI of responders was 29.8 (range 17.1-64.8) When asked to identify their BMI into four categories, 14% self-reported as “normal weight”, 3% as “underweight”, 39% as “a little overweight”, and 44% as “a lot overweight”. Self-reported BMI assessment was compared to actual BMI and good to moderate agreement was noted (weighted kappa 0.66). 85% of women correctly identified their BMI category. When asked if they were obese, 96% (43/45) of obese patients correctly answered “yes” (kappa 0.86). 52% (n=46) reported attempted weight loss following their diagnosis. Of those not attempting weight loss, reasons included: not needing to (37%), not wanting to (23%), not knowing how (14%), not having time (12%), and not having money (20%). Only 34% of patients reported being counseled by a gynecologic oncologist to lose weight. 92% of patients correctly identified obesity as a risk factor for EC. Conclusions: EC survivors are relatively knowledgeable about the role of obesity in EC and their own personal weight. Patients were generally motivated to make lifestyle changes after their cancer diagnosis. Unfortunately, only 1/3 of patients reported their providers encouraged weight loss. Gynecologic oncologists should take full advantage of the “teachable moment” for this highly obesity-driven cancer.
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