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Volume 14
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10.3390/healthcare14020231
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Lifestyle, Modifiable Behavioral Factors, and Biomarker Profiles in Uterine Lesions

by
Anna Mihaylova
1,*,
Antoniya Yaneva
2,
Angelina Mollova-Kyosebekirova
3,
Ekaterina Uchikova
4,
Desislava Bakova
1,
Mariya Koleva-Ivanova
3,
Mariana Parahuleva
5 and
Nikoleta Parahuleva
4
1
Department of Healthcare Management, Faculty of Public Health, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
2
Department of Medical Informatics, Biostatistics and E-Learning, Faculty of Public Health, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
3
Department of General and Clinical Pathology, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
4
Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
5
Universitätsklinikum Gießen und Marburg Standort Marburg, 35043 Marburg, Germany
*
Author to whom correspondence should be addressed.
Healthcare 2026, 14(2), 231; https://doi.org/10.3390/healthcare14020231
Submission received: 8 November 2025 / Revised: 6 January 2026 / Accepted: 14 January 2026 / Published: 16 January 2026
Versions Notes

Abstract

Background: Precursor endometrial lesions and endometrial cancer are strongly influenced by lifestyle-related risk factors, including obesity, low physical activity, and unfavorable dietary patterns. Identifying these factors is essential for early prevention and for improving health literacy among women. Objective: The objective of this study was to evaluate the influence of modifiable lifestyle factors on the likelihood of developing EIN and endometrial cancer in comparison with leiomyoma. Materials and Methods: A cross-sectional analytical study was conducted among 50 women, divided into three groups: leiomyoma (n = 20), EIN (n = 15), and endometrial cancer (n = 15). BMI, physical activity, dietary habits, sleep duration, stress levels, and smoking status were assessed. Statistical analysis included the Kruskal–Wallis test, correlation analysis, and logistic regression. Results: BMI was identified as an independent predictor of EIN/EC (OR = 1.29; p = 0.015). Women with EIN/EC demonstrated significantly lower levels of physical activity (p = 0.018). A clustering of behavioral risks was observed: higher BMI was associated with higher stress and shorter sleep duration. Conclusions: Modifiable lifestyle factors play a key role in the development of precursor and malignant endometrial conditions. Targeted interventions focusing on weight management, increased physical activity, and improved health literacy may reduce risk and improve quality of life among peri- and postmenopausal women.
Keywords: endometrial cancer; endometrial intraepithelial neoplasia (EIN); leiomyoma; body mass index (BMI); physical activity; behavioral risk factors; lifestyle; health literacy; prevention; quality of life endometrial cancer; endometrial intraepithelial neoplasia (EIN); leiomyoma; body mass index (BMI); physical activity; behavioral risk factors; lifestyle; health literacy; prevention; quality of life

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MDPI and ACS Style

Mihaylova, A.; Yaneva, A.; Mollova-Kyosebekirova, A.; Uchikova, E.; Bakova, D.; Koleva-Ivanova, M.; Parahuleva, M.; Parahuleva, N. Lifestyle, Modifiable Behavioral Factors, and Biomarker Profiles in Uterine Lesions. Healthcare 2026, 14, 231. https://doi.org/10.3390/healthcare14020231

AMA Style

Mihaylova A, Yaneva A, Mollova-Kyosebekirova A, Uchikova E, Bakova D, Koleva-Ivanova M, Parahuleva M, Parahuleva N. Lifestyle, Modifiable Behavioral Factors, and Biomarker Profiles in Uterine Lesions. Healthcare. 2026; 14(2):231. https://doi.org/10.3390/healthcare14020231

Chicago/Turabian Style

Mihaylova, Anna, Antoniya Yaneva, Angelina Mollova-Kyosebekirova, Ekaterina Uchikova, Desislava Bakova, Mariya Koleva-Ivanova, Mariana Parahuleva, and Nikoleta Parahuleva. 2026. "Lifestyle, Modifiable Behavioral Factors, and Biomarker Profiles in Uterine Lesions" Healthcare 14, no. 2: 231. https://doi.org/10.3390/healthcare14020231

APA Style

Mihaylova, A., Yaneva, A., Mollova-Kyosebekirova, A., Uchikova, E., Bakova, D., Koleva-Ivanova, M., Parahuleva, M., & Parahuleva, N. (2026). Lifestyle, Modifiable Behavioral Factors, and Biomarker Profiles in Uterine Lesions. Healthcare, 14(2), 231. https://doi.org/10.3390/healthcare14020231

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