Journal: Journal of obesity & metabolic syndrome
This narrative review synthesizes recent meta-analyses and key cohort data linking excess adiposity to cancer incidence, focusing on body mass index and waist circumference.
Key points:
- Across the 13 malignancies recognized as obesity-related, higher adiposity is consistently associated with increased cancer risk. Effect sizes vary by:
- Histologic subtype (e.g., stronger for esophageal adenocarcinoma than squamous cell carcinoma)
- Anatomic subsite (e.g., gastric cardia vs non-cardia)
- Sex and menopausal status
- Adiposity metric, with central adiposity (waist circumference) often conferring additional risk beyond BMI.
- Evidence is heterogeneous or less conclusive for certain cancers:
- Mixed or less consistent data for pancreas and thyroid.
- Emerging but not firmly established associations for oral cavity, melanoma, bladder, non-Hodgkin lymphoma, and leukemia.
- Prevention and weight loss:
- Observational studies and selected interventional data suggest that intentional weight loss—via lifestyle change, pharmacotherapy (including GLP-1 receptor agonists), or bariatric surgery—may reduce overall or site‑specific cancer incidence.
- Effect estimates are variable, and residual confounding and causality remain concerns.
- Overall conclusion:
- Convergent epidemiologic data and underlying biologic plausibility support obesity as a modifiable risk factor for multiple cancers.
- The authors call for standardized adiposity measures, consistent stratification, better confounder control, and adequately powered long-term randomized or quasi-experimental studies to refine effect estimates and enable more precise cancer prevention strategies in people with obesity.