Background
Endometrial or womb cancer is a common cancer in women and the number of cases is rising. This is due, in part, to increasing levels of obesity, which is a major risk factor for the disease. Whilst survival following endometrial cancer is generally excellent if diagnosed early, affected women are more likely to die early due to an increased risk of heart attacks and strokes and to have poorer quality of life. This review assessed the evidence for weight-loss interventions in overweight and obese endometrial cancer survivors to determine whether they were of benefit compared with usual care.

Study characteristics
We included three randomised controlled trials in which women were allocated at random to receive one of several interventions (treatments) and which involved 161 obese participants. The trials were conducted in the USA and the UK. All compared lifestyle advice (diet and exercise) plus self-help techniques (to encourage adherence to the advice) with usual care. The evidence is current to January 2018.

Key results
We found no benefit for endometrial cancer survivors from receiving lifestyle advice in terms of survival, cardiovascular events or quality of life, though such interventions were not associated with significant or serious harms to participants. They did, however, report higher rates of musculoskeletal symptoms, presumably due to increases in physical activity. Whilst some women lost weight with these interventions, others did not, meaning that overall there was little or no benefit.

Quality of the evidence
The quality of included studies was, however, low or very low and all were small in terms of the number of participants and not designed to specifically look at the effect of their intervention on survival. Additional high-quality studies are required in this field and currently there are five ongoing trials.