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Obesity Is Related to Increased Cancer Mortality

Controlling obesity might substantially reduce cancer mortality in the U.S. population.

We usually think of obesity as being associated with increased cardiovascular risk, but obesity also has been linked with cancer. In this prospective study sponsored by the American Cancer Society, researchers recorded self-reported height and weight of 900,000 American adults (mean age, 57) in 1982 and followed them for 16 years; information about cancer mortality was collected during that interval.

Compared with men whose body-mass index was in the normal range (18.5 to 24.9), men with marked obesity (BMI, 40.0) had significant increased cancer mortality (relative risk, 1.52). The analogous relative risk for women was 1.62. People with lesser degrees of obesity had lesser, but still significant, increases in cancer mortality. Among men, there were significant associations between higher BMI and higher rates of death from esophageal, stomach, colorectal, liver, gallbladder, pancreatic, prostate, and kidney cancers, and from non-Hodgkin's lymphoma, multiple myeloma, and leukemia. Among women, high BMI was associated with greater mortality from colorectal, liver, gallbladder, pancreatic, breast, uterine, cervical, ovarian, and kidney cancers, and from non-Hodgkin's lymphoma and multiple myeloma. Analyses were adjusted for many potential confounders, including smoking status, physical activity, alcohol use, fat consumption, and vegetable consumption.

Comment: If these estimates are valid, and if we could somehow prevent obesity in a substantial proportion of the population, then thousands of cancer deaths could be prevented annually. Editorialists note that the biologic mechanisms linking obesity and most cancers are not understood fully.

— Allan S. Brett, MD

Published in Journal Watch General Medicine May 2, 2003

Citation(s):

Calle EE et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003 Apr 24; 348:1625-38.

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Adami H-O and Trichopoulos D. Obesity and mortality from cancer. N Engl J Med 2003 Apr 24; 348:1623-4.

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• Medline abstract (Free)