European Journal of Epidemiology

, Volume 30, Issue 5, pp 397–412 | Cite as

A systematic review and meta-analysis of physical activity and endometrial cancer risk

  • Daniela SchmidEmail author
  • Gundula Behrens
  • Marlen Keimling
  • Carmen Jochem
  • Cristian Ricci
  • Michael Leitzmann


Physical activity is related to decreased endometrial cancer risk. However, a comprehensive investigation of activity domains, intensities, time periods in life, and potential interaction with body mass index is unavailable. We performed a meta-analysis of physical activity and endometrial cancer studies published through October 2014. We identified 33 eligible studies comprising 19,558 endometrial cancer cases. High versus low physical activity was related to reduced endometrial cancer risk [relative risk (RR) = 0.80; 95 % confidence interval (CI) 0.75–0.85]. The corresponding RRs for recreational activity, occupational activity, household activity, and walking were 0.84 (95 % CI 0.78–0.91), 0.81 (95 % CI 0.75–0.87), 0.70 (95 % CI 0.47–1.02), and 0.82 (95 % CI 0.69–0.97), respectively (\(P_{difference} = 0.88\)). Walking/biking for transportation, walking for recreation, and walking without specification revealed summary RRs of 0.70 (95 % CI 0.58–0.85), 0.94 (95 % CI 0.76–1.17), and 0.88 (95 % CI 0.52–1.50), respectively (\(P_{difference} = 0.13\)). Inverse associations were noted for light (RR 0.65; 95 % CI 0.49–0.86), moderate to vigorous (RR 0.83; 95 % CI 0.71–0.96), and vigorous activity (RR 0.80; 95 % CI 0.72–0.90; \(P_{difference} = 0.35\)). A statistically significant inverse relation was found for postmenopausal (RR 0.81; 95 % CI 0.67–0.97), but not premenopausal women (RR 0.74; 95 % CI 0.49–1.13; \(P_{difference} = 0.78\)). Physical activity performed during childhood/adolescence, young adulthood/midlife, and older age yielded RRs of 0.94 (95 % CI 0.82–1.08), 0.77 (95 % CI 0.58–1.01), and 0.69 (95 % CI 0.37–1.28), respectively (\(P_{difference} = 0. 5 1\)). An inverse relation was evident in overweight/obese (RR 0.69; 95 % CI 0.52–0.91), but not normal weight women (RR 0.97; 95 % CI 0.84–1.13; \(P_{difference} = 0.07\)). In conclusion, recreational physical activity, occupational physical activity, and walking/biking for transportation are related to decreased endometrial cancer risk. Inverse associations are evident for physical activity of light, moderate to vigorous, and vigorous intensities. The inverse relation with physical activity is limited to women who are overweight or obese.


Physical activity Endometrial cancer Meta-analysis 



We thank Dr. Helge Knuettel from the library of the University of Regensburg for his assistance in the literature search.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10654_2015_17_MOESM1_ESM.pptx (62 kb)
Supplementary Figure 1. Literature search strategy and study selection. (PPTX 62 kb)
10654_2015_17_MOESM2_ESM.eps (10 kb)
Supplementary Figure 2. Recreational physical activity and endometrial cancer risk according to a physical activity measure (MET-hours per week) with approximately similar categories. (EPS 10 kb)


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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Daniela Schmid
    • 1
    Email author
  • Gundula Behrens
    • 1
  • Marlen Keimling
    • 1
  • Carmen Jochem
    • 1
  • Cristian Ricci
    • 1
  • Michael Leitzmann
    • 1
  1. 1.Department of Epidemiology and Preventive MedicineUniversity of RegensburgRegensburgGermany

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