Association of sleep quality and urinary melatonin levels with endometrial cancer: A case control pilot study

Feb 23, 2026Industrial psychiatry journal

Links between sleep quality, melatonin levels, and risk of uterine cancer

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Abstract

The mean melatonin level among women with endometrial cancer was 6.72 ± 2.71 ng/mL, significantly lower than the 12.38 ± 6.64 ng/mL in healthy controls.

Women with endometrial cancer had a higher average score on the (8.77) compared to controls (6.27), indicating poorer sleep quality.
Sleep onset latency was significantly longer in patients with endometrial cancer (P = 0.002).
Sleep duration scores also differed significantly between cases and controls (P = 0.006).
Alterations in sleep quality and low melatonin levels may be associated with an increased risk of endometrial carcinoma.

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Endometrial cancer is the most common gynecologic malignancy globally. Recent studies suggest that alterations in circadian rhythm might be associated with an increased risk of endometrial carcinoma. To evaluate the association between sleep quality, urinary melatonin levels, and prevalence of endometrial cancer. A case control study was conducted among perimenopausal women with recently diagnosed endometrial cancer. Women with no history of cancer were recruited as controls. Sleep evaluation was done using the (PSQI). Urinary melatonin levels were measured using liquid chromatography tandem mass spectrometry methods. The sociodemographic variables (age, education, occupation, and diet) as well as the variables of PSQI scores and melatonin levels were compared between cases and healthy controls. The mean ± SD age of cases was 50.7 ± 11.2 (n = 18), and it does not differ significantly from the controls, 48.2 ± 2.6 (n = 18). The PSQI global scores mean (SD) among cases, 8.77 ± 3.76, was significantly higher as compared to controls, 6.27 ± 2.71 (P = 0.03). The sleep onset latency was significantly higher among patients (P = 0.002), and sleep duration scores are significantly different between cases and controls (P = 0.006). The melatonin level mean ± SD among cases, 6.72 ± 2.71 ng/mL, was significantly low as compared to controls, 12.38 ± 6.64 ng/mL (P = 0.006). Low melatonin levels along with sleep quality in endometrial carcinoma patients indicate that the malignancy might be associated with disturbances in the circadian rhythm.

Key numbers

8.77

Increase in Score

global scores among endometrial carcinoma patients

6.72 ng/mL

Decrease in Urinary Melatonin Levels

Urinary melatonin levels among endometrial carcinoma patients

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Association of sleep quality and urinary melatonin levels with endometrial cancer: A case control pilot study

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