A growing body of evidence suggests that certain lifestyle choices, like following a Mediterranean-style diet, staying active and reducing sedentary time, can help lower the risk of endometrial cancer, the sixth most common cancer among women worldwide.
But a new review published in Oncology Advances shows that the effectiveness of these habits may depend on individual factors like weight, genetics and metabolic health.
Researchers found that while diets rich in fruits, vegetables, whole grains and healthy fats are generally protective, the benefits can vary. For example, a Mediterranean diet was associated with a 13% lower risk of endometrial cancer overall, but that reduction wasn’t consistent across all body types, ethnicities or socioeconomic groups.
Exercise also played a key role. Walking for about 30 minutes most days was linked to a lower risk of cancer. But for people with obesity, more intense or longer workouts may be needed to see meaningful benefits. Sedentary behavior, on the other hand, was associated with up to a 30% higher risk.
The review also highlighted some surprising findings. While soy isoflavones may lower risk in populations with high habitual intake, they could have different effects in hormone-sensitive subgroups. And while oral contraceptives and hormonal IUDs reduce long-term endometrial cancer risk, the impact can vary based on weight and microbiome changes.
Perhaps most importantly, the paper called for more personalized prevention strategies. Genetic conditions like Lynch syndrome, associated with an earlier cancer onset and lower BMI, don’t always respond to lifestyle changes in the same way as sporadic cases. For these individuals, other approaches like low-dose aspirin may be more effective.
Ultimately, researchers say the best prevention strategies won’t be one-size-fits-all. Instead, future public health guidance may need to consider metabolic profiling, genetic risk and culturally specific lifestyle interventions to help more people benefit from preventive care.
This review was financially supported by several academic and provincial research initiatives in China, including the China Scholarship Council, Liaoning Province Science and Technology Program and Jinzhou Medical University.