The Obesity and Cancer Connection

News about obesity can be frequently found in newspapers, heard on the radio and television, and found on the Internet. These news stories address obesity trends and the obesity epidemic, including concerns about childhood obesity. They speak about the aggregate—the collective masses of individuals who have obesity—and don't tend to engage the individual in reflection or consideration about his or her own health status. That is, until recent news items highlighted the link between obesity and cancer. Linking an increased risk of some cancers with obesity serves as a different and louder type of alert that may offer a more frightening scenario than heart disease, hypertension, and diabetes. Cancer carries a different fear factor with it because, in large part, it sounds more deadly. Most people know of many others who have suffered with or died from cancer. Cancer treatment regimens are known to have unpleasant associated outcomes, such as nausea, fatigue, and hair loss. It is generally known that the life spans of people with cancer may be reduced and their quality of life may suffer. Pain is frequently associated with cancer. For centuries, cancer has been viewed as an insidious and dreaded disease. Linking it with obesity will be a chilling experience for many.

In a recent issue of USA Today, ¹ the newspaper published a front page story with the headline, “Obesity Linked to Specific Cancers, 33% of Americans Have Increased Risk.” The story was based on an analysis released by the American Institute for Cancer Research (AICR) that strongly linked breast, endometrial, kidney, colorectal, pancreas, esophagus, and gallbladder cancers to excess body fat. ² The AICR projects that approximately 100,500 cases of cancer are caused by obesity every year. The estimated numbers of specific cancers that are linked to excess body fat include: ²

49% of endometrial cancers = 20,700 cases/year

The link between cancer and obesity is also discussed in the National Cancer Institute (NCI) Fact Sheet about cancer and obesity, with a stated increased risk for the same cancers outlined in the AICR report. ³ Both the NCI and AICR explanations for the link between cancer and obesity include discussions about high levels of estrogen in obese women as well as long-term exposure to hormones and high levels of insulin and insulin-related growth factors in people with obesity that may promote certain tumor development.

When the AICR report was published, it received a lot of press and could be seen and heard repeatedly in newspapers and on television news. It reached millions of Americans through the media. We should think of this as laying the groundwork for a brief intervention or a brief discussion with patients about their obesity-related health risks and the risk of developing certain types of cancer. The link between cancer and obesity may provide an open door to have a frank discussion with patients who are obese and smoke or who are obese and have a family history of cancer. Raising the topic of obesity with patients who have one or more risk factors for certain cancers may be difficult for some providers, but it is the right thing to do. The link between obesity and cancer has moved the issue of obesity to the foreground, and providers should consider using it as a springboard for discussion and development of a plan to address their patients' obesity.