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Review
. 2023 Jan 12;15(2):485.
doi: 10.3390/cancers15020485.

Obesity and Cancer: A Current Overview of Epidemiology, Pathogenesis, Outcomes, and Management

Sukanya Pati  1 , Wadeed Irfan  2 , Ahmad Jameel  1 , Shahid Ahmed  1   3 , Rabia K Shahid  1
Affiliations
Review

Obesity and Cancer: A Current Overview of Epidemiology, Pathogenesis, Outcomes, and Management

Sukanya Pati et al. Cancers (Basel). .

Abstract

Background: Obesity or excess body fat is a major global health challenge that has not only been associated with diabetes mellitus and cardiovascular disease but is also a major risk factor for the development of and mortality related to a subgroup of cancer. This review focuses on epidemiology, the relationship between obesity and the risk associated with the development and recurrence of cancer and the management of obesity.

Methods: A literature search using PubMed and Google Scholar was performed and the keywords 'obesity' and cancer' were used. The search was limited to research papers published in English prior to September 2022 and focused on studies that investigated epidemiology, the pathogenesis of cancer, cancer incidence and the risk of recurrence, and the management of obesity.

Results: About 4-8% of all cancers are attributed to obesity. Obesity is a risk factor for several major cancers, including post-menopausal breast, colorectal, endometrial, kidney, esophageal, pancreatic, liver, and gallbladder cancer. Excess body fat results in an approximately 17% increased risk of cancer-specific mortality. The relationship between obesity and the risk associated with the development of cancer and its recurrence is not fully understood and involves altered fatty acid metabolism, extracellular matrix remodeling, the secretion of adipokines and anabolic and sex hormones, immune dysregulation, and chronic inflammation. Obesity may also increase treatment-related adverse effects and influence treatment decisions regarding specific types of cancer therapy. Structured exercise in combination with dietary support and behavior therapy are effective interventions. Treatment with glucagon-like peptide-1 analogues and bariatric surgery result in more rapid weight loss and can be considered in selected cancer survivors.

Conclusions: Obesity increases cancer risk and mortality. Weight-reducing strategies in obesity-associated cancers are important interventions as a key component of cancer care. Future studies are warranted to further elucidate the complex relationship between obesity and cancer with the identification of targets for effective interventions.

Keywords: body mass index; cancer; cancer outcomes; cancer risk; epidemiology; malignancy; obesity; overweight; treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Potential mechanism of obesity-induced dysfunction of adipose tissue on tumor initiation, progression, and recurrence. Excess fat accumulation results in dysfunction of adipose tissue that causes increased production of proinflammatory cytokines, sex hormones, and lipid metabolites, along with impaired adipocyte-derived cytokines or adipokines profiles and insulin resistance. The altered adipose tissue is a source of ECM remodeling, fibrosis, cancer-associated adipocytes, impaired microbial metabolism, adipocyte progenitors, inflammation, and altered micro-environment. These factors contribute to tumor initiation, growth, and recurrence.
Figure 2
Figure 2
Structured exercise in combination with dietary support and behavior therapy are effective interventions for all cancer survivors. Treatment with glucagon-like peptide-1 analogues and bariatric surgery can be considered in selected cancer survivors.
See this image and copyright information in PMC

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