Women with metabolic syndrome face higher risk of gynaecological cancers, finds study

Women with metabolic syndrome (MetS) face a significantly elevated risk of developing several gynaecological cancers, according to a new systematic review published in the Indian Journal of Medical Research (IJMR). 

The analysis, conducted by researchers from the ICMR–National Institute of Reproductive and Child Health (NIRRCH), Mumbai, M.S. Ramaiah University of Applied Sciences, Bengaluru, and Amrita Institute of Medical Sciences (AIMS), Kochi, assessed global evidence on the link between MetS and cancers of the ovary, endometrium, cervix, vagina and vulva.

Metabolic syndrome is a complex cluster of metabolic disorders that includes obesity, hypertension, hyperglycaemia, high triglycerides and low levels of high-density lipoprotein (HDL) cholesterol. Its prevalence increases sharply with age – from about 13% among young adults (18–29 years) to nearly 50% by the age of 50 – and is more common among women (35%) than men (26%).

Across study types

The review found that women with MetS had markedly higher odds of developing several gynaecological cancers. Based on case-control studies, the odds ratio (OR) for endometrial cancer was 1.99, indicating nearly double the odds of developing the disease among women with MetS compared to those without. For ovarian cancer, the odds were even higher (OR 3.44), suggesting a threefold increase in risk. Cervical cancer also showed elevated odds (OR 1.9), while smaller but significant associations were noted for vaginal and vulvar cancers.

In cross-sectional studies, the odds of developing endometrial cancer were more than twice as high (OR 2.64) in women with MetS. Similarly, cohort studies, which track participants over time, revealed a 45% higher risk (hazard ratio, HR 1.45) of endometrial cancer, a 26% higher risk (HR 1.26) of cervical cancer, a 49% higher risk (HR 1.49) of vulvar cancer, and a 54% higher risk (HR 1.54) of vaginal cancer among women with MetS compared to those without.

India-specific data

“It was surprising to note that despite the growing burden of MetS and associated non-communicable diseases in India, we did not find any Indian study that could be included in this analysis,” said Susan Idicula-Thomas, corresponding author and scientist at ICMR–NIRRCH. “This underscores a significant gap in our understanding of comorbidity risks among Indian women. Without population-specific data, it becomes difficult to translate these insights into actionable strategies,” she said.

Indra Kundu, PhD scholar at ICMR–NIRRCH and first author of the paper, said that the wide variations in study design and population characteristics across the reviewed literature made comparing risk estimates challenging.

Preventive strategies

Emphasising the public health implications, Denny John from M.S. Ramaiah University of Applied Sciences said, “The study underscores the importance of integrating women with existing metabolic disorders, such as diabetes, into preventive health programmes. This is crucial for both primary prevention and early detection.”

Based on the findings, the authors recommend that management of metabolic syndrome should become a key component in the prevention and treatment of gynaecological cancers. They stress the need for primary prevention and early detection efforts, especially for women with fully developed metabolic conditions such as diabetes.

The researchers also called for large-scale, prospective cohort studies in the Indian context.