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Using quality improvement to increase the awareness of obesity among endometrial cancer patients
  1. Diogo Torres1,
  2. Anousheh Shafa1,
  3. Sara Klennert1,
  4. Alexis Hokenstad1,
  5. Megan Bird1,
  6. Megan Weinhold1,
  7. Manpreet S Mundi2,
  8. Carrie Langstraat1 and
  9. Amanika Kumar1
  1. 1 Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
  2. 2 Endocrinology, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Diogo Torres, Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USA; dt2j{at}


Objective To increase discussion about obesity and endometrial cancer and referrals to weight loss clinic in patients with newly diagnosed low-risk endometrial cancer.

Methods A multidisciplinary team used a quality improvement methodology to increase patient awareness about obesity and endometrial cancer. Target population included patients <80 years old with a body mass index ≥30 kg/m2 who underwent surgery at our institution and had a final diagnosis of complex hyperplasia or stage I, grade 1–2 endometrioid endometrial cancer. A toolkit was developed for the intervention. Clinical characteristics, discussion about obesity, and referrals to a weight loss clinic were abstracted for a historic and intervention cohort. Data for the two cohorts were compared using chi-square, Fisher’s exact test, and t-test.

Results 54 patients from the historic cohort and 53 from the intervention cohort met inclusion criteria. Clinical characteristics were balanced between the groups. Discussion about obesity increased from 11.1% (6/54) to 79.2% (42/53) after implementing the toolkit (p<0.001). Referrals to the weight loss clinic also increased from 3.7% (2/54) to 26.4% (14/53) after implementing the toolkit (p=0.001), but in both groups only 50% of those referred actually attended the weight loss clinic. No clinical characteristics were identified as associated with being more likely to have documented conversations or referrals.

Conclusions A multidisciplinary quality-improvement project can be used to increase discussion about obesity and referral to a weight loss clinic in patients with low-risk endometrial cancer. Increasing patient awareness of the connection between obesity and endometrial cancer may have implications on the long-term health of endometrial cancer survivors.

  • obesity
  • endometrial cancer
  • quality improvement
  • weight loss
  • bariatric surgery
  • cancer survivorship

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  • Contributors Study conception and design: AK, CLL, MSM, MB, MW, SK. Acquisition of data: DT, AH, AS, SK. Analysis and interpretation of data: DT, AK, SK, CL. Drafting of manuscript: DT, AS. Critical revision: AK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.