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Comparative Study
. 2015 Jan;16(1):36-46.
doi: 10.1016/S1470-2045(14)71123-4. Epub 2014 Nov 26.

Global burden of cancer attributable to high body-mass index in 2012: a population-based study

Melina Arnold #  1 , Nirmala Pandeya #  2 , Graham Byrnes  3 , Prof Andrew G Renehan  4 , Gretchen A Stevens  5 , Prof Majid Ezzati  6   7 , Jacques Ferlay  1 , J Jaime Miranda  8 , Isabelle Romieu  9 , Rajesh Dikshit  10 , David Forman  1 , Isabelle Soerjomataram  1
Affiliations
Comparative Study

Global burden of cancer attributable to high body-mass index in 2012: a population-based study

Melina Arnold et al. Lancet Oncol. 2015 Jan.

Abstract

Background: High body-mass index (BMI; defined as 25 kg/m(2) or greater) is associated with increased risk of cancer. To inform public health policy and future research, we estimated the global burden of cancer attributable to high BMI in 2012.

Methods: In this population-based study, we derived population attributable fractions (PAFs) using relative risks and BMI estimates in adults by age, sex, and country. Assuming a 10-year lag-period between high BMI and cancer occurrence, we calculated PAFs using BMI estimates from 2002 and used GLOBOCAN2012 data to estimate numbers of new cancer cases attributable to high BMI. We also calculated the proportion of cancers that were potentially avoidable had populations maintained their mean BMIs recorded in 1982. We did secondary analyses to test the model and to estimate the effects of hormone replacement therapy (HRT) use and smoking.

Findings: Worldwide, we estimate that 481,000 or 3.6% of all new cancer cases in adults (aged 30 years and older after the 10-year lag period) in 2012 were attributable to high BMI. PAFs were greater in women than in men (5.4% vs 1.9%). The burden of attributable cases was higher in countries with very high and high human development indices (HDIs; PAF 5.3% and 4.8%, respectively) than in those with moderate (1.6%) and low HDIs (1.0%). Corpus uteri, postmenopausal breast, and colon cancers accounted for 63.6% of cancers attributable to high BMI. A quarter (about 118,000) of the cancer cases related to high BMI in 2012 could be attributed to the increase in BMI since 1982.

Interpretation: These findings emphasise the need for a global effort to abate the increasing numbers of people with high BMI. Assuming that the association between high BMI and cancer is causal, the continuation of current patterns of population weight gain will lead to continuing increases in the future burden of cancer.

Funding: World Cancer Research Fund International, European Commission (Marie Curie Intra-European Fellowship), Australian National Health and Medical Research Council, and US National Institutes of Health.

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Figures

Figure 1
Figure 1
Cancer cases (in thousands) attributable to excess body mass index by world region in 2012
Figure 2
Figure 2
Population attributable fractionofnew cancer cases due to excess body mass index in 2012 in (a) males and (b) females
Figure 2
Figure 2
Population attributable fractionofnew cancer cases due to excess body mass index in 2012 in (a) males and (b) females
Figure 3
Figure 3
Estimated number of cancer cases (in thousands) attributable to excess body mass index in 2012 by cancer site in males and female OAC = oesophageal adenocarcinoma
Figure 4
Figure 4
Age-standardised incidence rate of obesity-related cancers (per 100,000, standardised to the world standard population, light bars) and the fraction attributable to excess body mass index (in rates, dark bars) by world region and sex in 2012 Obesity-related cancers: oesophageal adenocarcinoma, pancreas, kidney, postmenopausal breast, ovary, corpus uteri, gallbladder (females only), colon, rectum
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