Why Women Dealing With High BMI Can Be At Higher Risk Of Ovarian Cancer
Cancer is a word that still scares us all. Is a higher BMI a risk factor or a trigger for the development of ovarian cancer? Here’s what an Obstetrician and Gynaecologist has to say about this.
By Dr Nidhi Sharma Chauhan
Is there a link between a woman’s body mass index (BMI) and her risk of developing ovarian cancer? Among gynaecological cancers, ovarian cancer remains one of the most complex to understand in terms of risk factors, especially when it comes to body weight. While obesity is a known risk factor for several cancers, including breast and uterine malignancies, the evidence linking BMI and ovarian cancer is less clear and often debated in medical literature.
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Weak But Notable Association
Unlike uterine cancer, where high BMI is strongly associated with increased risk, the link between obesity and ovarian cancer appears to be weaker and more nuanced. Several large-scale studies have shown conflicting results. A hospital-based case-control study conducted at the Roswell Park Cancer Institute, for example, found no significant association between high BMI and ovarian cancer in postmenopausal women. However, it did find that obese premenopausal women (BMI ≥30) had over twice the risk of developing ovarian cancer compared to their underweight or normal-weight peers (adjusted OR = 2.19).
What Might Explain This?
The mechanism is still being understood, but some biological theories offer insights. Adipose (fat) tissue produces oestrogens, and in excess, this unopposed oestrogen could potentially influence cancer development. This is particularly well-documented in endometrial cancer. In ovarian cancer, the effect may be less direct but still relevant. Some recent studies suggest that higher levels of circulating oestrogen may contribute to the risk of borderline ovarian malignancies or early epithelial ovarian cancers.
Additionally, obesity-related hormonal imbalances, such as hyperinsulinemia and increased levels of insulin-like growth factor (IGF-1) and androgens, have been shown to promote cellular proliferation. One hypothesis is that these changes may contribute to the development of epithelial ovarian cancer, the most common type of ovarian malignancy.
Hormone Therapy And Hereditary Risk
Another aspect to consider is the interaction between BMI and other risk modifiers. Women on postmenopausal hormone therapy, especially unopposed oestrogen, may face different risk profiles depending on their BMI. Additionally, the hereditary component of ovarian cancer remains a dominant risk factor. Mutations in the BRCA1 and BRCA2 genes, for instance, can elevate a woman’s lifetime risk of ovarian cancer to as high as 70%, regardless of her body weight.
Obesity May Impact Survival, Not Just Risk
Even if obesity does not strongly increase the chances of developing ovarian cancer, it does seem to affect treatment outcomes and survival. Studies show that women with lower BMIs tend to have better post-surgical recovery and improved 5-year survival rates compared to those with higher BMIs. This is an important reason why maintaining a healthy weight is still critical — not just for prevention, but also for improving prognosis in case of diagnosis.
The Bigger Picture
It is crucial to understand that risk does not imply certainty. Not all women with high BMI will develop ovarian cancer, and many women who do may have no known risk factors at all. That said, obesity is a modifiable factor, unlike age or genetics. So, even a weak association—especially in premenopausal women —makes it a point worth considering in both public health messaging and clinical risk assessment.
In conclusion, while the link between high BMI and ovarian cancer isn't as strong or clear-cut as with some other cancers, emerging evidence suggests a nuanced, possibly age and hormone-dependent relationship. Ongoing research is key to untangling this complexity, but until then, maintaining a healthy weight remains a prudent choice for overall cancer prevention and improved health outcomes.
The author, Dr Nidhi Sharma Chauhan, a Consultant Obstetrician and Gynaecologist with Saifee Hospital, Mumbai.
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]
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