The obesity paradox in cancer: clinical insights and perspectives

  • Ilaria Trestini
  • Luisa Carbognin
  • Clelia Bonaiuto
  • Giampaolo Tortora
  • Emilio Bria
Original Article
  • 129 Downloads
Part of the following topical collections:
  1. Obesity Paradox

Abstract

A series of evidence demonstrated that obesity represents an established risk factor for an increase in the incidence of multiple cancer types and for poor cancer survival. Nevertheless, recent studies suggested that, in a series of cancers, patients with a normal body mass index (BMI) have worse outcomes than obese patients. This phenomenon, named ‘obesity paradox’ or ‘reverse epidemiology’ in cancer, is not well understood and presents controversial aspects. Therefore, this review aims to explore the available studies concerning the relationship between obesity and cancer incidence or survival and to highlight the hypothetical explanations and the methodological framework. In this regard, we underline the limits of BMI as a potential marker of adiposity and the relevance to assessing body composition, beyond the body size. Further studies are needed to define the impact of obesity in cancer patients, to tailor weight management after cancer diagnosis and to hopefully improve overall clinical outcome.

Keywords

Obesity Cancer Obesity paradox Body mass index Body composition Sarcopenia 

Notes

Acknowledgements

The authors are supported by a grant of the Lega Italiana contro i Tumori (LILT-Bando di ricerca sanitaria 2016–5 × 1000 anno 2014).

Compliance with ethical standards

Conflict of interest

I.T., L.C. C.B., and G.T. declare that they have no conflict of interest. E.B. received honoraria or speakers’ fee from MSD, Astra-Zeneca, Celgene, Pfizer, Helsinn, Eli-Lilly, BMS, Novartis, and Roche, and he received research support from A.I.R.C. (Associazione Italiana Ricerca sul Cancro), I.A.S.L.C. (International Association for the Study of Lung Cancer), L.I.L.T. (Lega Italiana per la Lotta contro i Tumori), Fondazione Cariverona, Astra-Zeneca, Roche, and Open Innovation.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study the informed consent was not required.

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Authors and Affiliations

  1. 1.U.O.C. OncologyUniversity of Verona, Azienda Ospedaliera Universitaria IntegrataVeronaItaly

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