Intro: Researchers say there are shared biological mechanisms between the two conditions – elevated insulin levels, hormonal imbalance, chronic inflammation and adipose tissue dysfunction
MUMBAI: A new ICMR-NIRRCH study has found that women with metabolic syndrome, a cluster of conditions including obesity, high blood pressure, elevated blood sugar and abnormal cholesterol, face a significantly higher risk of developing gynaecological cancers.
Published on October 10, 2025, in the Indian Journal of Medical Research (IJMR), the study was done by a systematic review and meta-analysis led by researchers from ICMR-NIRRCH, Mumbai, and MS Ramaiah University of Applied Sciences, Bengaluru.
The team analysed evidence from 25 international studies to understand how metabolic disorders influence women’s risk of cancer. The review found that women with metabolic syndrome were almost three times more likely to develop ovarian cancer and twice as likely to develop uterine or endometrial cancer compared to women without the condition.
The risks of developing cervical, vaginal and vulvar cancers were also higher, though to a lesser degree.
“Metabolic syndrome is on the rise, and cancers are also rising in India. What makes this particularly important is that metabolic syndrome is preventable. Our systematic review looked at global data and found that women with metabolic syndrome have a consistently higher risk of developing gynaecological cancers. Even though the studies came from other countries, the underlying biological link will not change for Indian women,” said Dr Susan Idicula-Thomas, corresponding author and senior scientist at ICMR–NIRRCH.
The analysis drew from more than 13,000 global studies. However, only 25 met the criteria for inclusion, including case studies of many women who had both the medical conditions.
The researchers pointed to shared biological mechanisms between metabolic syndrome and cancer. Elevated insulin levels, hormonal imbalance, chronic inflammation and adipose (fat) tissue dysfunction are key factors behind both.
“When insulin levels remain high, they trigger abnormal cell proliferation and reduce the body’s ability to eliminate damaged cells, both pathways that can lead to tumour growth,” explained Thomas.
“Obesity further worsens the hormone imbalance, increasing estrogen and androgen levels, which are linked to endometrial and ovarian cancers.”
“Key components of metabolic syndrome, such as insulin resistance, chronic inflammation and obesity, create an internal environment that promotes abnormal cell growth and survival, making the body more prone to cancer development,” said the researchers.
The study also highlights how chronic inflammation can disturb normal cell function in the uterus and ovaries.
Despite India witnessing a sharp rise in both metabolic disorders and cancer cases, the researchers found no Indian study suitable for inclusion in the review.
“It was surprising to note that we did not find a single Indian study that fit the quality criteria,” Dr Idicula-Thomas said. “This reflects a serious research gap. Without population-specific data, it is difficult to develop screening guidelines or preventive strategies tailored to Indian women.”
Public health expert and one of the authors of the study, Dr Denny John, from the department of allied health science, MS Ramaiah University of Applied Sciences, said the findings underline the importance of linking non-communicable disease programmes with cancer prevention. Metabolic syndrome affects nearly 35% of adult Indian women.
“Women with diabetes, hypertension, or obesity should automatically be flagged for regular gynaecological check-ups. Early detection is crucial, especially when we know the risk factors are largely preventable,” he said.
“India urgently needs systematic, large-scale studies to establish the level of risk among Indian women. We know that metabolic syndrome, defined by any three of five conditions such as obesity, hypertension and diabetes, is hormone-related and therefore hormone-sensitive. Uterine cancer appears to carry the highest risk because of hormone imbalances. Once we can quantify this risk, it will guide early interventions and primary prevention strategies, especially among postmenopausal women,” said Dr Thomas.