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Obesity as a risk factor for certain types of cancer

Summary and Conclusions

In conclusion, obesity has been associated with increased risk for a number of different types of cancer. The evidence has been most consistent for endometrial cancer, breast cancer in postmenopausal women, and renal cell cancer. More variable results have been reported for colorectal, prostate and pancreatic cancer.

Possible mechanisms by which obesity may influence cancer risk include alteration in hormonal patterns, including sex hormones and insulin, and factors such as the distribution of body fat and changes in adiposity at different ages. The increasing prevalence of obesity in many parts of the world emphasizes the importance of learning more about the relationship between obesity and cancer and the mechanisms involved in their interaction.

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Abbreviations

BMI:

body mass index

References

  1. Lew, E.A., and Garfinkel, L. (1979) Variations in Mortality by Weight Among 750,000 Men and Women, J. Chronic Dis. 32, 563–576.

    PubMed  CAS  Article  Google Scholar 

  2. Seidell, J.C., Deurenberg, P., and Hautvast, J.G.A.J. (1987) Obesity and Fat Distribution in Relation to Health—Current Insights and Recommendations, World Rev. Nutr. Diet. 50, 57–91.

    PubMed  CAS  Google Scholar 

  3. Møller, U., Mellemgaard, A., Lindvig, K., and Olsen, J.H. (1994) Obesity and Cancer Risk: A Danish Record-Linkage Study, Eur. J. Cancer 30A, 344–350.

    PubMed  Article  Google Scholar 

  4. Le Marchand, L. (1992) Anthropometry, Body Composition, and Cancer, in Macronutrients, Investigating Their Role in Cancer (Micozzi, M.S., and Moon, T.E., eds.) pp. 321–342, Marcel Dekker, Inc., New York.

    Google Scholar 

  5. Anon. (1996). Obesity, Cancer Causes & Control 7, 511–513.

    Google Scholar 

  6. Hill, M.J. (1996) Overweight and Cancer, Eur. J. Cancer Prevention 5, 151–152.

    CAS  Article  Google Scholar 

  7. Colditz, G.A. (1992) Economic Costs of Obesity, Am. J. Clin. Nutr. 55 (Suppl. 2), 503S-507S.

    PubMed  CAS  Google Scholar 

  8. Stamler, J. (1993) Epidemic Obesity in the United States, Arch. Int. Med. 153, 1040–1044.

    CAS  Article  Google Scholar 

  9. Williamson, D.F. (1993) Descriptive Epidemiology of Body Weight and Weight Change in U.S. Adults, Ann. Int. Med. 119, 646–649.

    PubMed  CAS  Google Scholar 

  10. Kuczmarski, R.J., Flegal, K.M., Campbell, S.M., and Johnston, C.L. (1994) Increasing Prevalence of Overweight Among US Adults. The National Health and Nutrition Examination Surveys, 1960 to 1991, J. Am. Med. Assoc. 272, 206–211.

    Article  Google Scholar 

  11. Seidell, J.C. (1995) Obesity in Europe: Scaling an Epidemic, Int. J. Obes. 19 (Suppl. 3), S1-S4.

    Google Scholar 

  12. Gofin, J., Abramson, J.H., Kark, J.D., and Epstein, L. (1996) The Prevalence of Obesity and Its Changes Over Time in Middle-aged and Elderly Men and Women in Jerusalem, Int. J. Obes. 20, 260–266.

    CAS  Google Scholar 

  13. Al-Nuaim, A.R., Bangboye, E.A., and Al-Herbish, A. (1996) The Pattern of Growth and Obesity in Saudi Arabian Male School Children, Int. J. Obes. 20, 1000–1005.

    CAS  Google Scholar 

  14. Fogelholm, M., Männistö, S., Vartiainen, E., and Pietmen, P. (1996) Determinants of Energy Balance and Overweight in Finland 1982 to 1992, Int. J. Obes. 20, 1097–1104.

    CAS  Google Scholar 

  15. Barth, N., Ziegler, A., Himmelmann, G.W., Coners, H., Wabitsch, M., Henninghausen, K., Mayer, H., Renschmidt, H., Schäfer, H., and Hebebrand, J. (1997) Significant Weight Gains in a Sample of Obese Children and Adolescents Between 1985 and 1995, Int. J. Obes. 21, 122–126.

    CAS  Article  Google Scholar 

  16. Schottenfeld, D. (1995) Epidemiology of Endometrial Neoplasia, J. Cell. Biochem. 23 (Suppl.), 151–159.

    CAS  Article  Google Scholar 

  17. Ballard-Barbash, R., and Swenson, C.A. (1996) Body Weight Estimation of Risk for Breast and Endometrial Cancer, Am. J. Clin. Nutr. 63 (Suppl.), 437s-441s.

    PubMed  CAS  Google Scholar 

  18. Hill, H.A., and Austin, H. (1996) Nutrition and Endometrial Cancer, Cancer Causes & Control 7, 19–32.

    CAS  Article  Google Scholar 

  19. Törnberg, S.A., and Carstensen, J.M. (1994) Relationship Between Quetelet's Index and Cancer of Breast and Female Genital Tract in 47,000 Women Followed for 25 Years, Br. J. Cancer 69, 358–361.

    PubMed  Google Scholar 

  20. Le Marchand, L., Wilkens, L.R., and Mi, M.-P. (1991) Early-Age Body Size, Adult Weight Gain and Endometrial Cancer Risk, Int. J. Cancer 48, 807–811.

    PubMed  Google Scholar 

  21. Levi, F., La Vecchia, C., Negri, E., Parazzini, F., and Franceschi, S. (1992) Body Mass at Different Ages and Subsequent Endometrial Cancer Risk, Int. J. Cancer 50, 567–571.

    PubMed  CAS  Google Scholar 

  22. Elliott, E.A., Matanoski, G.M., Rosenshein, N.B., Grunbine, F.C., and Diamond, E.L. (1990) Body Fat Patterning in Women with Endometrial Cancer, Gynecol. Oncol. 39, 253–258.

    PubMed  CAS  Article  Google Scholar 

  23. Schapira, D.V., Kumar, N.B., Lyman, G.H., Cavanagh, D., Roberts, W.S., and LaPolla, J. (1991) Upper-Body Fat Distribution and Endometrial Cancer Risk, J. Am. Med. Assoc. 266, 1808–1811.

    CAS  Article  Google Scholar 

  24. Swanson, C.A., Potischman, N., Wilbanks, G.D., Twiggs, L.B., Mortel, R., Berman, M.L., Barrett, R.J., Baumgartner, R.N., and Brinton, L.A. (1993) Relation of Endometrial Cancer Risk to Past and Contemporary Body Size and Body Fat Distribution, Cancer Epidemiol., Biomarkers Prevention 2, 321–327.

    CAS  Google Scholar 

  25. Shu, X.O., Brinton, L.A., Zheng, W., Swanson, C.A., Hatch, M.C., Gao, Y.T., and Fraumeni, J.F., Jr. (1992) Relation of Obesity and Body Fat Distribution to Endometrial Cancer in Shanghai, China, Cancer Res. 52, 3865–3870.

    PubMed  CAS  Google Scholar 

  26. Lapidus, L., Helgesson, O., Merck, C., and Bjorntorp, P. (1988) Adipose Tissue Distribution and Female Carcinomas: A 12-Year Follow-up of Participants in the Population Study of Women in Gotherburg, Sweden, Int. J. Obest. 12, 361–368.

    CAS  Google Scholar 

  27. Folsom, A.R., Kaye, S.A., Potter, J.D., and Prineas, R.J. (1989) Association of Incident Carcinoma of the Endometrium with Body Weight and Fat Distribution in Older Women. Early Findings of the Iowa Women's Health Study, Cancer Res. 49, 6828–6831.

    PubMed  CAS  Google Scholar 

  28. Austin, H., Austin, J.M., Jr., Partridge, E.E., Hatch, K.D., and Shingleton, H.M. (1991) Endometrial Cancer, Obesity, and Body Fat Distribution, Cancer Res. 51, 568–572.

    PubMed  CAS  Google Scholar 

  29. Key, T.J.A., and Pike, M.C. (1988) The Dose-Effect Relationship Between Unopposed Oestrogens and Endometrial Mitotic Rate: Its Central Role in Explaining and Predicting Endometrial Cancer Risk, Br. J. Cancer 57, 205–212.

    PubMed  CAS  Google Scholar 

  30. Key, T.J. (1995) Hormones and Cancer in Humans, Mutat. Res. 333, 59–67.

    PubMed  CAS  Google Scholar 

  31. Judd, H.L., Lucas, W.E., and Yen, S.S. (1976) Serum 17β-Stradiol and Estrome Levels in Postmenopausal Women With and Without Endometrial Cancer, J. Clin. Endocrinol. Metab. 43, 272–278.

    PubMed  CAS  Google Scholar 

  32. MacDonald, P.C., and Siiteri, P.K. (1974) The Relationship Between the Extraglandular Production of Estrone and the Occurrence of Endometrial Neoplasia, Gynecol. Oncol. 2, 259–263.

    PubMed  CAS  Article  Google Scholar 

  33. Davidson, B.J., Gambone, J.C., Lagasse, L.D., Castaldo, T.W., Hammond, G.L., Siiteri, P.K., and Judd, H.L. (1981) Free Estradiol in Postmenopausal Women With and Without Endometrial Cancer, J. Clin. Endocrinol. Metab. 52, 404–408.

    PubMed  CAS  Article  Google Scholar 

  34. Kirchner, M.A., Samojlik, E., Drejka, M., Szmal, E., Schneider, G., and Ertel, N. (1990) Androgen-Estrogen Metabolism in Women with Upper Body versus Lower Body Obesity, J. Clin. Endocrinol. Metab. 70, 473–479.

    Google Scholar 

  35. Baanders-van Halewyn, E.A., Blankenstein, M.A., Thijssen, J.H.H., de Ridder, C.M., and de Waard, F. (1996) Comparative Study of Risk Factors for Hyperplasia and Cancer of the Endometrium, Eur. J. Cancer Prevention 5, 105–112.

    CAS  Article  Google Scholar 

  36. Potischman, N., Hoover, R.N., Brinton, L.A., Siiteri, P., Dorgan, J.F., Swenson, C.A., Berman, M.L., Mortel, R., Twiggs, L.B., Barrett, R.J., Wilbanks, G.D., Persky, V., and Lurain, J.R. (1996) Case-Control Study of Endogenous Steroid Hormones and Endometrial Cancer, J. Nat. Cancer Inst. 88, 1127–1135.

    PubMed  CAS  Google Scholar 

  37. Tretli, S. (1989) Height and Weight in Relation to Breast Cancer Morbidity and Mortality. A Prospective Study of 570,000 Women in Norway, Int. J. Cancer. 44, 23–30.

    PubMed  CAS  Google Scholar 

  38. Bruning, P.F., Bonfrèr, J.M.G., Hard, A.A.M., van Noord, P.A.H., van der Hoeven, H., Collette, H.J.A., Battermann, J.J., de Jong-Bakker, M., Nooijen, W.J., and De Waard, F. (1992) Body Measurements, Estrogen Availability and the Risk of Human Breast Cancer: A Case-Control Study, Int. J. Cancer 51, 14–19.

    PubMed  CAS  Google Scholar 

  39. Hunter, D.J., and Willett, W.C. (1993) Diet, Body Size, and Breast Cancer, Epidemiol. Rev. 15, 110–132.

    PubMed  CAS  Google Scholar 

  40. Hunter, D.J., and Willett, W.C. (1994) Diet, Body Build, and Breast Cancer Annu. Rev. Nutri 14, 393–418.

    CAS  Article  Google Scholar 

  41. Ballard-Barbash, R. (1994) Anthropometry and Breast Cancer. Body Size—A Moving Target, Cancer 74, 1090–1100.

    PubMed  CAS  Article  Google Scholar 

  42. Yong, L.-C., Brown, C.C., Schatzkin, A., and Schairer, C. (1996) Prospective Study of Relative Weight and Risk of Breast Cancer: The Breast Cancer Detection Demonstration Project Follow-up Study 1979 to 1987–1989, Am. J. Epidemiol. 143, 985–995.

    PubMed  CAS  Google Scholar 

  43. Ziegler, R.G., Hoover, R.N., Nomura, A.M.Y., West, D.W., Wu, A.H., Fike, M.C., Lake, A.J., Horn-Ross, P.L., Kolonel, L.N., Siiteri, P.K., and Frameni, J.F., Jr. (1996) Relative Weight. Weight Change, Height, and Breast Cancer Risk in Asian-American Women, J. Nat. Cancer Inst. 88, 650–660.

    PubMed  CAS  Google Scholar 

  44. Ursin, G., Longnecker, M.P., Haile, R.W., and Greenland, S. (1995) A Meta-analysis of Body Mass Index and Risk of Premenopausal Breast Cancer, Epidemiology 6, 137–141.

    PubMed  CAS  Google Scholar 

  45. Pathak, D.R., and Whittemore, A.S. (1992) Combined Effects of Body Size, Parity, and Menstrual Events on Breast Cancer Incidence in Seven Countries, Am. J. Epidemiol. 135, 153–168.

    PubMed  CAS  Google Scholar 

  46. Deslypere, J.P. (1995) Obesity and Cancer, Metab Clin. Exp. 44 (Suppl. 3), 24–27.

    PubMed  CAS  Google Scholar 

  47. Schapira, D.V., Clark, R.A., Wolff, P.A., Jarrett, A.R., Kumar, N.B., and Aziz, N.M. (1994) Visceral Obesity and Breast Cancer Risk, Cancer 74, 632–639.

    PubMed  CAS  Article  Google Scholar 

  48. Swanson, C.A., Coates, R.J., Schoenberg, J.B., Malone, K.E., Gammon, M.D., Stanford, J.L., Shorr, I.J., Potischman, N.A., and Brinton, L.A. (1996) Body Size and Breast Cancer Risk Among Women Under Age 45 Years, Am. J. Epidemiol. 143, 698–706.

    PubMed  CAS  Google Scholar 

  49. Goodwin, P.J., and Boyd, N.F. (1990) Body Size and Breast Cancer Prognosis: A Critical Review of the Literature, Breast Cancer Res. Treat. 16, 205–214.

    PubMed  CAS  Article  Google Scholar 

  50. Zhang, S., Folsom, A.R., Sellers, T.A., Kushi, L., and Potter, J.D. (1995) Better Breast Cancer Survival for Postmenopausal Women Who Are Less Overweight and Eat Less Fat. The Iowa Women's Health Study, Cancer 76, 275–283.

    PubMed  CAS  Article  Google Scholar 

  51. Wing, R.R., Matthews, K.A., Kuller, L.H., Meilahn, E.N., and Plantinga, P.L. (1991) Weight Gain at the Time of Menopause, Arch. Int. Med. 151, 97–101.

    CAS  Article  Google Scholar 

  52. Schapira, D.V., Kumar, N.B., and Lyman, G.H. (1991) Estimate of Breast Cancer Risk Reduction with Weight Loss, Cancer 67, 2622–2625.

    PubMed  CAS  Article  Google Scholar 

  53. Siiteri, P.K. (1987) Adipose Tissue as a Source of Hormones, Am. J. Clin. Nutr. 45, 277–282.

    PubMed  CAS  Google Scholar 

  54. Hershcopt, R.J., and Bradlow, H.L. (1987) Obesity, Diet, Endogenous Estrogens, and the Risk of Hormone-Sensitive Cancer, Am. J. Clin. Nutr. 45, 283–289.

    Google Scholar 

  55. Potischman, N., Swanson, C.A., Siiteri, P., and Hoover, R.N. (1996) Reversal of Relation Between Body Mass and Endogenous Estrogen Concentrations with Menopausal Status, J. Nat. Cancer Inst. 88, 756–758.

    PubMed  CAS  Google Scholar 

  56. Gerber, M. (1997) Re: Reversal of Relation Between Body Mass and Endogenous Estrogen Concentrations with Menopausal Status, J. Nat. Cancer Inst. 89, 661–662.

    PubMed  CAS  Article  Google Scholar 

  57. Russo, J., Rivera, B., and Russo, I.H. (1992) Influence of Age and Parity on the Development of the Human Breasts, Breast Cancer Res. Treat. 23, 211–218.

    PubMed  CAS  Article  Google Scholar 

  58. Carroll, K.K., Gammal, E.B., and Plunkett, E.R. (1968) Dietary Fat and Mammary Cancer, Can. Med. Assoc. J. 98, 590–594.

    PubMed  CAS  Google Scholar 

  59. Rose, D.P., Connolly, J.M., Rayburn, J., and Coleman, M. (1995) Influence of Diets Containing Eicosapentaenoic or Docosahexaenoic Acid on Growth and Metastasis of Breast Cancer Cells in Nude Mice, J. Nat. Cancer Inst. 87, 587–592.

    PubMed  CAS  Google Scholar 

  60. Carroll, K.K., and Parenteau, H.I. (1991). A Proposed Mechanism for Effects of Diet on Mammary Cancer, Nutr. Cancer 16, 79–83.

    PubMed  CAS  Article  Google Scholar 

  61. Trichopoulos, D., and Lipman, R.D. (1992) Mammary Gland Mass and Breast Cancer Risk, Epidemiology 3, 523–526.

    PubMed  CAS  Google Scholar 

  62. Brinton, L.A. (1996). Editorial Hormones and Risk of Cancers of the Breast and Ovary, Cancer Causes & Control 7, 569–571.

    CAS  Article  Google Scholar 

  63. Kaaks, R. (1996) Nutrition, Hormones, and Breast Cancer: Is Insulin the Missing Link? Cancer Causes & Control 7, 605–625.

    CAS  Article  Google Scholar 

  64. Bruning, P.F., Bonfrèr, J.M.G., van Noord, P.A.H., Hard, A.A.M., de Jong-Bakker, M., and Nooijen, W.J. (1992) Insulin Resistance and Breast Cancer Risk, Int. J. Cancer 52, 511–516.

    PubMed  CAS  Google Scholar 

  65. Kolonel, L.N. (1995) Nutrition and Prostate Cancer, Cancer Causes & Control 7, 83–94.

    Google Scholar 

  66. Andersson, S.O., Wolk, A., Bergelström, R., Adami, H.-O., Engholm, G., Englund, A., and Nyrén, O. (1997) Body Size and Prostate Cancer: A 20-year Follow-up Study Among 135,006 Swedish Construction Workers, J. Nat. Cancer Inst. 89, 385–389.

    PubMed  CAS  Article  Google Scholar 

  67. Severson, R.K., Grove, J.S., Nomura, A.M.Y., and Stemmerman, G.N. (1988) Body Mass and Prostatic Cancer: a Prospective Study, Br. Med. J. 297, 713–715.

    CAS  Article  Google Scholar 

  68. Daniell, H.W. (1996) A Better Prognosis for Obese Men with Prostate Cancer, J. Urol. 155, 220–225.

    PubMed  CAS  Article  Google Scholar 

  69. Ji, B.-T., Hatch, M.C., Chow, W.-H., McLaughlin, J.K., Dai, Q., Howe, G.R., Gao, Y.-T., and Fraumeni, J.F., Jr. (1996) Anthropometric and Reproductive Factors and the Risk of Pancreatic Cancer: A Case-Control Study in Shanghai, China, Int. J. Cancer 66, 432–440.

    PubMed  CAS  Article  Google Scholar 

  70. Potter, J.D. (1996) Nutrition and Colorectal Cancer, Cancer Causes & Control 7, 127–146.

    CAS  Article  Google Scholar 

  71. Shike, M. (1996) Body Weight and Colon Cancer, Am. J. Clin. Nutr. 63 (Suppl.), 442S-444S.

    PubMed  CAS  Google Scholar 

  72. Suadicani, P., Hein, H.O., and Gyntelberg F. (1993) Height, Weight, and Risk of Colorectal Cancer. An 18-Year Follow-up in a Cohort of 5249 Men, Scand. J. Gastroenterol. 28, 285–288.

    PubMed  CAS  Google Scholar 

  73. Kreger, B.E., Anderson, K.M., Schatzkin, A., and Splansly, G.L. (1992) Serum Cholesterol Level, Body Mass Index and the Risk of Colon Cancer, The Framingham Study, Cancer 70, 1038–1043.

    PubMed  CAS  Article  Google Scholar 

  74. Must, A., Jacques, P.F., Dallal, G.F., Bajema, C.J., and Dietz, W.H. (1992) Long-term Morbidity and Mortality of Overweight Adolescents. A Follow-up of the Harvard Growth Study of 1922 to 1935, N. Engl. J. Med. 327, 1350–1355.

    PubMed  CAS  Article  Google Scholar 

  75. Le Marchand, L., Wilkens, L.R., and Mi, M.-P. (1992) Obesity in Youth and Middle Age and Risk of Colorectal Cancer in Men, Cancer Causes & Control 3, 349–354.

    Article  Google Scholar 

  76. Lee, I.M., and Paffenbarger, R.S., Jr. (1992) Quetelet's Index and Risk of Colon Cancer in College Alumni, J. Nat. Cancer Inst. 84, 1326–1331.

    PubMed  CAS  Google Scholar 

  77. Slattery, M.L., Potter, J., Caen, B., Edwards, S., Coates, A., Ma, K.-N., and Berry, T.D. (1997) Energy Balance and Colon Cancer-Beyond Physical Activity, Cancer Res. 57, 75–80.

    PubMed  CAS  Google Scholar 

  78. Giovannuci, E., Ascherio, A., Rimm, E.B., Colditz, G.A., Stampfer, M.J., and Willett, W.C. (1995) Physical Activity, Obesity, and Risk for Colon Cancer and Adenoma in Men, Ann. Int. Med. 122, 327–334.

    Google Scholar 

  79. Giovannuci, E., Colditz, G.A., Stampfer, M.J., and Willett, W.C., (1996) Physical Activity, Obesity and Risk of Colorectal Adenoma in Women (United States), Cancer Causes & Control 7, 253–263.

    Article  Google Scholar 

  80. Giovannuci, E. (1995) Insulin and Colon Cancer, Cancer Causes & Control 6, 164–179.

    Article  Google Scholar 

  81. Phillips, R.L., and Snowdon, D.A. (1985) Dietary Relationships with Fatal Colorectal Cancer Among Seventh-Day Adventists, J. Nat. Cancer Inst. 74, 307–317.

    PubMed  CAS  Google Scholar 

  82. Wolk, A., Lindblad, P., and Adami, H.-O. (1996) Nutrition and Renal Cell Cancer, Cancer Causes & Control 7, 5–18.

    CAS  Article  Google Scholar 

  83. Albrektsen, G., Heuch, I., and Kvåle, G. (1996) Reproductive Factors and Incidence of Epithelial Ovarian Cancer: A Norwegian Prospective Study, Cancer Causes & Control 7, 421–427.

    CAS  Article  Google Scholar 

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Correspondence to K. K. Carroll.

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This paper was prepared as one of the background documents for the WHO Consultation on Obesity (Geneva, Switzerland, 3–5 June 1997). For further details, please see the report of the Consultation, Obesity: preventing and managing the global epidemic (WHO/NUT/NCD/97.2).

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Carroll, K.K. Obesity as a risk factor for certain types of cancer. Lipids 33, 1055–1059 (1998). https://doi.org/10.1007/s11745-998-0305-8

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Keywords

  • Breast Cancer
  • Obesity
  • Postmenopausal Woman
  • Breast Cancer Risk
  • Endometrial Cancer