Metabolic syndrome is a cluster of conditions that collectively increase the risk of heart disease, stroke, and type 2 diabetes. It is typically diagnosed when a person exhibits at least three of the following five risk factors: high blood pressure, high blood sugar, obesity, low levels of high-density lipoprotein (HDL or "good" cholesterol), and elevated levels of triglycerides. The latest research, conducted by scientists from the Indian Council of Medical Research-National Institute of Research in Reproductive and Child Health, Amrita Hospital in Kochi, and MS Ramaiah University of Applied Sciences, has been published in the Indian Journal of Medical Research. It is based on a meta-analysis of 25 studies from various countries, including India, the United States, China, the United Kingdom, and South Korea, among others. These studies included case-control studies (which compare two groups to identify disease-related factors), cross-sectional studies (which collect data from a population at a single point in time), and cohort studies (which follow participants over extended periods). The researchers concluded that "women with metabolic syndrome are associated with an increased risk of gynaecological cancers regardless of study design, type of gynaecological cancer, and definitions of metabolic syndrome." Independent oncologists India Today spoke with said the findings reflected their observations. Dr Parminder Kaur, consultant gynaecologic oncologist at CK Birla Hospital in Delhi, pointed out that metabolic syndrome is increasingly being diagnosed in younger women, particularly those with Polycystic Ovarian Syndrome (PCOS). When PCOS presents with features like obesity, hypertension, diabetes, and abnormal lipid levels, it further raises the risk of gynecological cancers. According to the GLOBOCAN 2022 report released by the World Health Organisation-International Agency for Research on Cancer (WHO-IARC), approximately 1.47 million gynaecological cancer cases were reported worldwide. In India, cervical and ovarian cancers are the most prevalent among all gynaecological malignancies. The country reported nearly 1.27 lakh cervical cancers in 2022 while 80,000 women lost lives due to this form of malignancy that year. HIGHEST RISK OF ENDOMETRIAL AND CERVICAL CANCERS The review study showed that women with metabolic syndrome have particularly high odds of developing cancers of the reproductive system. Based on case-control studies, the odds ratio for endometrial cancer was 1.99-indicating nearly double the risk for women with the syndrome. For ovarian cancer, the odds were even higher at 3.44, implying more than a threefold increase in risk. Cervical cancer had an odds ratio of 1.9, while smaller but still significant associations were observed for vaginal and vulvar cancers. In cross-sectional studies, the odds of developing endometrial cancer in women with metabolic syndrome were more than twice as high (2.64). Cohort studies, where participants were tracked over time, showed a 45% increased risk of endometrial cancer, a 26% higher risk of cervical cancer, a 49% increased risk of vulvar cancer, and a 54% higher risk of vaginal cancer among those with metabolic syndrome compared to those without it. UNDERSTANDING LINK BETWEEN DYSREGULATED METABOLISM AND CANCERS The researchers explained that the elevated risk may stem from overlapping pathophysiological mechanisms. Key contributors to metabolic syndrome-such as insulin resistance, chronic inflammation, and obesity-are known to create a biological environment that favours cancer development. These factors can enhance cellular proliferation, reduce programmed cell death (apoptosis), and promote metastasis. High circulating insulin levels can also lead to increased levels of oestrogen and testosterone, further increasing the risk of endometrial and ovarian cancers. Obesity disrupts the natural hormonal balance and can elevate serum androgen levels in women, leading to fat accumulation in reproductive organs and other metabolic disturbances that impair healthy cellular functioning. Dr Kaur emphasised that in women with metabolic syndrome, the immune system is often compromised. For instance, cervical cancer is caused by the Human Papilloma Virus (HPV), and a weakened immune system may fail to clear the infection, thereby increasing the risk of malignancy. Similarly, if genetic damage occurs in ovarian cells, the body's impaired ability to repair this damage may also elevate cancer risk. Endometrial cancer is the most common gynecological cancer associated with metabolic syndrome and is increasingly being diagnosed in younger women, especially those with PCOS. KEEPING A CHECK ON BMI CRUCIAL Dr Kaur stressed that reducing body weight and maintaining a healthy Body Mass Index (BMI) can significantly lower the risk of diabetes, hypertension, cardiovascular disease, and endometrial cancer. Dr Tirathram Kaushik, senior consultant in gynaecology and surgical oncology at HCG Cancer Centre in Mumbai, noted that the findings reaffirm what is often observed in clinical practice: that metabolic disturbances such as obesity and high blood sugar can lead to hormonal and inflammatory changes that fuel cancer development. He added that this is why healthcare providers strongly advocate for weight management, blood sugar control, and regular physical activity to help reduce the risk of these cancers.