Institute of Epidemiology & Health Care


Diet, nutrition and physical activity in endometrial cancer survivors

Author D. Koutoukidis
Author A. Lanceley
Author M.T. Knobf
Author R.J. Beeken
Abstract Endometrial cancer survivors comprise a high-risk group for obesity-related comorbidities. Healthy eating and physical activity can lead to better health and well-being, but this population may experience difficulties adopting healthy lifestyle practices. Personalised behaviour change programmes that are feasible, acceptable, and cost-effective are needed. Using various methodologies, this doctoral research aimed to develop and pilot a healthy eating and physical activity program. Through a systematic literature review and meta-analysis, study 1 demonstrated preliminary evidence that obesity is positively associated with overall mortality. Expanding the review, study 2 indicated that a healthy lifestyle is positively associated with health-related quality of life. Study 3 primarily piloted the instruments and procedures for the trial. Study 4, using qualitative methodology, suggested that interventions should incorporate recommendations on managing late-treatment effects, and behaviour change techniques for cognitive, practical, and social barriers to healthy lifestyle changes. Based on this feedback, an evidence-based weight management programme was adapted using the intervention mapping systematic framework in study 5. Subsequently, the programme was piloted in a phase II, individually randomized, parallel, controlled, two-site, pilot clinical trial in study 6. Adult endometrial cancer survivors (n = 60) who had been diagnosed with endometrial cancer within the previous 3 years and were not on active treatment were assigned in a 1:1 ratio through minimisation to either the 8-week, group-based, behaviour-change programme with weekly 90-min sessions about healthy eating and physical activity or usual care. Follow-up assessments were conducted at 8 and 24 weeks from the baseline assessment. The intervention, which focused on self-monitoring, goal setting, and self-incentives, was feasible in terms of recruitment, adherence, and retention. It also showed promising effectiveness. The study results will inform the development of a randomised controlled trial to test if the programme can improve the health and quality of life of this population.