# Lifestyle, Modifiable Behavioral Factors, and Biomarker Profiles in Uterine Lesions

**Authors:** Anna Mihaylova, Antoniya Yaneva, Angelina Mollova-Kyosebekirova, Ekaterina Uchikova, Desislava Bakova, Mariya Koleva-Ivanova, Mariana Parahuleva, Nikoleta Parahuleva

PMC · DOI: 10.3390/healthcare14020231 · 2026-01-16

## TL;DR

This study shows that lifestyle factors like obesity and low physical activity are linked to higher risk of uterine lesions and cancer, suggesting that behavior changes could help prevent these conditions.

## Contribution

The study identifies BMI and physical activity as independent predictors of endometrial intraepithelial neoplasia and cancer.

## Key findings

- BMI was an independent predictor of EIN/EC with an odds ratio of 1.29.
- Women with EIN/EC had significantly lower physical activity levels.
- Higher BMI was associated with increased stress and shorter sleep duration.

## Abstract

Background: Precursor endometrial lesions and endometrial cancer are strongly influenced by lifestyle-related risk factors, including obesity, low physical activity, and unfavorable dietary patterns. Identifying these factors is essential for early prevention and for improving health literacy among women. Objective: The objective of this study was to evaluate the influence of modifiable lifestyle factors on the likelihood of developing EIN and endometrial cancer in comparison with leiomyoma. Materials and Methods: A cross-sectional analytical study was conducted among 50 women, divided into three groups: leiomyoma (n = 20), EIN (n = 15), and endometrial cancer (n = 15). BMI, physical activity, dietary habits, sleep duration, stress levels, and smoking status were assessed. Statistical analysis included the Kruskal–Wallis test, correlation analysis, and logistic regression. Results: BMI was identified as an independent predictor of EIN/EC (OR = 1.29; p = 0.015). Women with EIN/EC demonstrated significantly lower levels of physical activity (p = 0.018). A clustering of behavioral risks was observed: higher BMI was associated with higher stress and shorter sleep duration. Conclusions: Modifiable lifestyle factors play a key role in the development of precursor and malignant endometrial conditions. Targeted interventions focusing on weight management, increased physical activity, and improved health literacy may reduce risk and improve quality of life among peri- and postmenopausal women.

## Linked entities

- **Diseases:** endometrial cancer (MONDO:0002447), leiomyoma (MONDO:0001572)

## Full-text entities

- **Diseases:** endometrial cancer (MESH:D016889), leiomyoma (MESH:D007889), endometrial lesions (MESH:D014591), obesity (MESH:D009765), EC (MESH:D005955)
- **Species:** Homo sapiens (human, species) [taxon 9606]

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Source: https://tomesphere.com/paper/PMC12841236