Skip to main content

Abstract

Obesity is a strong risk factor for multiple types of cancer. The mechanisms underlying this association are multiple and include increased systemic inflammation, increased alterations in the systemic hormonal milieu, and direct paracrine tumor-promoting effects of adipose tissue, adipose tissue stem cells, and mature adipocytes. These complex mechanisms generate a carcinogenic milieu in multiple tissues in obesity.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38.

    Article  PubMed  Google Scholar 

  2. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569–78.

    Article  PubMed  Google Scholar 

  3. Leung CC, Lam TH, Yew WW, Chan WM, Law WS, Tam CM. Lower lung cancer mortality in obesity. Int J Epidemiol. 2011;40:174–82.

    Article  PubMed  Google Scholar 

  4. Giovannucci E, Rimm EB, Liu Y, et al. Body mass index and risk of prostate cancer in U.S. health professionals. J Natl Cancer Inst. 2003;95:1240–4.

    Article  PubMed  Google Scholar 

  5. Engeland A, Tretli S, Bjorge T. Height, body mass index, and prostate cancer: a follow-up of 950,000 Norwegian men. Br J Cancer. 2003;89:1237–42.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. MacInnis RJ, English DR. Body size and composition and prostate cancer risk: systematic review and meta-regression analysis. Cancer Causes Control. 2006;17(8):989–1003.

    Article  PubMed  Google Scholar 

  7. Pfeiler G, Königsberg R, Hadji P, Fitzal F, Maroske M, Dressel-Ban G, Zellinger J, Exner R, Seifert M, Singer C, Gnant M, Dubsky P. Impact of body mass index on estradiol depletion by aromatase inhibitors in postmenopausal women with early breast cancer. Br J Cancer. 2013;109(6):1522–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Choi Y, Park B, Jeong BC, et al. Body mass index and survival in patients with renal cell carcinoma: a clinical-based cohort and meta-analysis. Int J Cancer. 2013;132(3):625–34.

    Article  PubMed  CAS  Google Scholar 

  9. Wang J, Myles B, Wei C, Chang JY, Hofstetter WL, Ajani JA, Swisher SG, Cox JD, Komaki R, Liao Z, Lin SH. Obesity and outcomes in patients treated with chemoradiotherapy for esophageal carcinoma. Dis Esophagus. 2014;27(2):168–75.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Renehan AG. The “obesity paradox” and survival after colorectal cancer: true or false? Cancer Causes Control. 2014;25(10):1419–22.

    Article  PubMed  Google Scholar 

  11. Hotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science. 1993;259(5091):87–91.

    Article  PubMed  CAS  Google Scholar 

  12. Lind MH, Rozell B, Wallin RP, van Hogerlinden M, Ljunggren HG, Toftgard R, et al. Tumor necrosis factor receptor 1-mediated signaling is required for skin cancer development induced by NF-kappaB inhibition. Proc Natl Acad Sci U S A. 2004;101(14):4972–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Kitakata H, Nemoto-Sasaki Y, Takahashi Y, Kondo T, Mai M, Mukaida N. Essential roles of tumor necrosis factor receptor p55 in liver metastasis of intrasplenic administration of colon 26 cells. Cancer Res. 2002;62(22):6682–7.

    PubMed  CAS  Google Scholar 

  14. Camp NJ, Slattery ML. Classification tree analysis: a statistical tool to investigate risk factor interactions with an example for colon cancer (United States). Cancer Causes Control. 2002;13:813–23.

    Article  PubMed  Google Scholar 

  15. Savage SA, Abnet CC, Mark SD, Qiao YL, Dong ZW, Dawsey SM, et al. Variants of the IL8 and IL8RB genes and risk for gastric cardia adenocarcinoma and esophageal squamous cell carcinoma. Cancer Epidemiol Biomarkers Prev. 2004;13(12):2251–7.

    PubMed  CAS  Google Scholar 

  16. Cheng H, Wang L, Mollica M, Re AT, Wu S, Zuo L. Nitric oxide in cancer metastasis. Cancer Lett. 2014. pii: S0304-3835(14)00351-6. doi: 10.1016/j.canlet.2014.07.014. [Epub ahead of print].

    Google Scholar 

  17. Biswas DK, Shi Q, Baily S, Strickland I, Ghosh S, Pardee AB, et al. NF-kappa B activation in human breast cancer specimens and its role in cell proliferation and apoptosis. Proc Natl Acad Sci U S A. 2004;101(27):10137–42.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. Duffey DC, Chen Z, Dong G, Ondrey FG, Wolf JS, Brown K, et al. Expression of a dominant-negative mutant inhibitor kappa B alpha of nuclear factor-kappaB in human head and neck squamous cell carcinoma inhibits survival, proinflammatory cytokine expression, and tumor growth in vivo. Cancer Res. 1999;59(14):3468–74.

    PubMed  CAS  Google Scholar 

  19. Saijo Y, Tanaka M, Miki M, et al. Proinflammatory cytokine IL-1 β promotes tumor growth of Lewis lung carcinoma by induction of angiogenic factors: in vivo analysis of tumor-stromal interaction. J Immunol. 2002;169:469–75.

    Article  PubMed  CAS  Google Scholar 

  20. Voronov E, Shouval DS, Krelin Y, et al. IL-1 is required for tumor invasiveness and angiogenesis. Proc Natl Acad Sci U S A. 2003;100:2645–50.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  21. Williamson RT. On the treatment of glycosuria and diabetes mellitus with sodium salicylate. Br Med J. 1901;1(2100):760–2.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  22. Faghihimani E, Aminorroaya A, Rezvanian H, Adibi P, Ismail-Beigi F, Amini M. Salsalate improves glycemic control in patients with newly diagnosed type 2 diabetes. Acta Diabetol. 2013;50(4):537–43.

    Article  PubMed  CAS  Google Scholar 

  23. Larsen CM, Faulenbach M, Vaag A, Vølund A, Ehses JA, Seifert B, Mandrup-Poulsen T, Donath MY. Interleukin-1 receptor antagonist in type 2 diabetes mellitus. N Engl J Med. 2007;356:1517–26.

    Article  PubMed  CAS  Google Scholar 

  24. Ursini F, Naty S, Grembiale RD. Infliximab and insulin resistance. Autoimmun Rev. 2010;9(8):536–9.

    Article  PubMed  CAS  Google Scholar 

  25. Bertagnolli MM, Eagle CJ, Zauber AG, et al. Celecoxib for the prevention of sporadic colorectal adenomas. N Engl J Med. 2006;355:873–84.

    Article  PubMed  CAS  Google Scholar 

  26. Arber N, Eagle CJ, Spicak J, et al. Celecoxib for the prevention of colorectal adenomatous polyps. N Engl J Med. 2006;355:885–95.

    Article  PubMed  CAS  Google Scholar 

  27. Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4(8):579–91.

    Article  PubMed  CAS  Google Scholar 

  28. Schoen RE, et al. Increased blood glucose and insulin, body size, and incident colorectal cancer. J Natl Cancer Inst. 1999;91:1147–54.

    Article  PubMed  CAS  Google Scholar 

  29. Lukanova A, Zeleniuch-Jacquotte A, Lundin E, Micheli A, Arslan AA, Rinaldi S, Muti P, Lenner P, Koenig KL, Biessy C, Krogh V, Riboli E, Shore RE, Stattin P, Berrino F, Hallmans G, Toniolo P, Kaaks R. Prediagnostic levels of C-peptide, IGF-I, IGFBP-1-2 and-3 and risk of endometrial cancer. Int J Cancer. 2004;108:262–8.

    Article  PubMed  CAS  Google Scholar 

  30. Frasca F, Pandini G, Sciacca L, et al. The role of insulin receptors and IGF-I receptors in cancer and other diseases. Arch Phys Biochem. 2008;114(1):23–37.

    Article  CAS  Google Scholar 

  31. Cox ME, Gleave ME, Zakikhani M, et al. Insulin receptor expression by human prostate cancers. Prostate. 2009;69(1):33–40.

    Article  PubMed  CAS  Google Scholar 

  32. Wu Y, Yakar S, Zhao L, Hennighausen L, LeRoith D. Circulating insulin-like growth factor-I levels regulate colon cancer growth and metastasis. Cancer Res. 2002;62(4):1030–5.

    PubMed  CAS  Google Scholar 

  33. Missmer SA, Eliassen AH, Barbieri RL, Hankinson SE. Endogenous estrogen, androgen, and progesterone concentrations and breast cancer risk among postmenopausal women. J Natl Cancer Inst. 2004;96:1856–65.

    Article  PubMed  CAS  Google Scholar 

  34. Allen NE, Key TJ, Dossus L, Rinaldi S, Cust A, Lukanova A, Peeters PH, Onland-Moret NC, Lahmann PH, Berrino F, Panico S, Larrañaga N, Pera G, Tormo MJ, Sánchez MJ, Ramón Quirós J, Ardanaz E, Tjønneland A, Olsen A, Chang-Claude J, Linseisen J, Schulz M, Boeing H, Lundin E, Palli D, Overvad K, Clavel-Chapelon F, Boutron-Ruault MC, Bingham S, Khaw KT, Bueno-de-Mesquita HB, Trichopoulou A, Trichopoulos D, Naska A, Tumino R, Riboli E, Kaaks R. Endogenous sex hormones and endometrial cancer risk in women in the European Prospective Investigation into Cancer and Nutrition (EPIC). Endocr Relat Cancer. 2008;15(2):485–97.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  35. Purohit A, Newman SP, Reed MJ. The role of cytokines in regulating estrogen synthesis: implications for the etiology of breast cancer. Breast Cancer Res. 2002;4:65–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  36. Pugeat M, Nader N, Hogeveen K, Raverot G, Déchaud H, Grenot C. Sex hormone-binding globulin gene expression in the liver: drugs and the metabolic syndrome. Mol Cell Endocrinol. 2010;316(1):53–9.

    Article  PubMed  CAS  Google Scholar 

  37. Key TJ, Appleby PN, Reeves GK, Roddam A, Dorgan JF, Longcope C, Stanczyk FZ, Stephenson Jr HE, Falk RT, Miller R, Schatzkin A, Allen DS, Fentiman IS, Key TJ, Wang DY, Dowsett M, Thomas HV, Hankinson SE, Toniolo P, Akhmedkhanov A, Koenig K, Shore RE, Zeleniuch-Jacquotte A, Berrino F, Muti P, Micheli A, Krogh V, Sieri S, Pala V, Venturelli E, Secreto G, Barrett-Connor E, Laughlin GA, Kabuto M, Akiba S, Stevens RG, Neriishi K, Land CE, Cauley JA, Kuller LH, Cummings SR, Helzlsouer KJ, Alberg AJ, Bush TL, Comstock GW, Gordon GB, Miller SR, Longcope C, Endogenous Hormones Breast Cancer Collaborative Group. Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. J Natl Cancer Inst. 2003;95(16):1218–26.

    Article  PubMed  CAS  Google Scholar 

  38. Tchernof A, Nolan A, Sites CK, Ades PA, Poehlman ET. Weight loss reduces C-reactive protein levels in obese postmenopausal women. Circulation. 2002;105:564–9.

    Article  PubMed  Google Scholar 

  39. Christou NV, Lieberman M, Sampalis F, Sampalis JS. Bariatric surgery reduces cancer risk in morbidly obese patients. Surg Obes Relat Dis. 2008;4:691–5.

    Article  PubMed  Google Scholar 

  40. Ahn J, Schatzkin A, Lacey Jr JA, Albanes D, Ballard-Barbash R, Adams KF, Kipnis V, Mouw T, Hollenbeck AR, Leitzmann MF. Adiposity, adult weight change, and postmenopausal breast cancer risk. Arch Intern Med. 2008;167:2091–100.

    Article  Google Scholar 

  41. Rose DP, Komninou D, Stephenson GD. Obesity, adipocytokines, and insulin resistance in breast cancer. Obes Rev. 2004;5:153–65.

    Article  PubMed  CAS  Google Scholar 

  42. Maehle BO, Tretli S. Pre-morbid body mass index in breast cancer: reversed effect on survival in hormone receptor negative patients. Breast Cancer Res Treat. 1996;41:123–30.

    Article  PubMed  CAS  Google Scholar 

  43. Dallal CM, Brinton LA, Bauer DC, Buist DS, Cauley JA, Hue TF, Lacroix A, Tice JA, Chia VM, Falk R, Pfeiffer R, Pollak M, Veenstra TD, Xu X, Lacey Jr JV, B ~ FIT Research Group. Obesity-related hormones and endometrial cancer among postmenopausal women: a nested case-control study within the B ~ FIT cohort. Endocr Relat Cancer. 2013;20(1):151–60.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  44. Tworoger SS, Eliassen AH, Kelesidis T, et al. Plasma adiponectin concentrations and risk of incident breast cancer. J Clin Endo Metab. 2007;92(4):1510–6.

    Article  CAS  Google Scholar 

  45. Cust AE, Kaaks R, Friedenreich C, et al. Plasma adiponectin levels and endometrial cancer risk in pre- and post-menopausal women. J Clin Endo Met. 2007;92(1):255–63.

    Article  CAS  Google Scholar 

  46. Wei EK, Giovannucci E, Fuchs CS, Willett WC, Mantzoros CS. Low plasma adiponectin levels and risk of colorectal cancer in men: a prospective study. J Natl Cancer Inst. 2005;97(22):1688–94.

    Article  PubMed  CAS  Google Scholar 

  47. Ribatti D, Belloni AS, Nico B, Di Comite M, Crivellato E, Vacca A. Leptin–leptin receptor are involved in angiogenesis in human hepatocellular carcinoma. Peptides. 2008;29:1596–602.

    Article  PubMed  CAS  Google Scholar 

  48. Gonzalez RR, Leavis PC. A peptide derived from the human leptin molecule is a potent inhibitor of the leptin receptor function in rabbit endometrial cells. Endocrine. 2003;21(2):185.

    Article  PubMed  CAS  Google Scholar 

  49. Surmacz E. Leptin and adiponectin: emerging therapeutic targets in breast cancer. J Mammary Gland Biol Neoplasia. 2013;18(3-4):321–32.

    Article  PubMed  Google Scholar 

  50. Mathur A, Zyromski NJ, Pitt HA, Al-Azzawi H, Walker JJ, Saxena R, Lillemoe KD. Pancreatic steatosis promotes dissemination and lethality of pancreatic cancer. J Am Coll Surg. 2009;208(5):989–94.

    Article  PubMed  Google Scholar 

  51. Yamaguchi J, et al. Prognostic impact of marginal adipose tissue invasion in ductal carcinoma of the breast. Am J Clin Pathol. 2008;130:382–8.

    Article  PubMed  Google Scholar 

  52. Rio MC. The role of cancer-associated adipocytes (CAA) in the dynamic interaction between the tumor and the host. In: Mueller MM, Fusenig NE, editors. Tumor-associated fibroblasts and their matrix, vol. 4. Netherlands: Springer; 2011. p. 111–23.

    Chapter  Google Scholar 

  53. Manabe Y, et al. Mature adipocytes, but not preadipocytes, promote the growth of breast carcinoma cells in collagen gel matrix culture through cancer-stromal cell interactions. J Pathol. 2003;201(2):221–8.

    Article  PubMed  Google Scholar 

  54. Amemori S, et al. Adipocytes and preadipocytes promote the proliferation of colon cancer cells in vitro. Am J Physiol Gastro Liver Physiol. 2007;292(3):G923–9.

    Article  CAS  Google Scholar 

  55. White PB, True EM, Ziegler KM, Wang SS, Swartz-Basile DA, Pitt HA, Zyromski NJ. Insulin, leptin, and tumoral adipocytes promote murine pancreatic cancer growth. J Gastrointest Surg. 2010;12:1888–93.

    Article  Google Scholar 

  56. Tokuda Y, Satoh Y, Fujiyama C, Toda S, Sugihara H, Masaki Z. Prostate cancer cell growth is modulated by adipocyte-cancer cell interaction. BJU Int. 2003;91(7):716–20.

    Article  PubMed  CAS  Google Scholar 

  57. Zhang Y, Daquinag A, Traktuev DO, Amaya-Manzanares F, Simmons PJ, March KL, Pasqualini R, Arap W, Kolonin MG. White adipose tissue cells are recruited by experimental tumors and promote cancer progression in mouse models. Cancer Res. 2009;69(12):5259–66.

    Article  PubMed  CAS  Google Scholar 

  58. Nieman KM, Kenny HA, Penicka CV, Ladanyi A, Buell-Gutbrod R, Zillhardt MR, Romero IL, Carey MS, et al. Adipocytes promote ovarian cancer metastasis and provide energy for rapid tumor growth. Nat Med. 2011;17(11):1498–503.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  59. Bochet L, Lehuédé C, Dauvillier S, Wang YY, Dirat B, Laurent V, Dray C, Guiet R, et al. Adipocyte-derived fibroblasts promote tumor progression and contribute to the desmoplastic reaction in breast cancer. Cancer Res. 2013;73(18):5657–68.

    Article  PubMed  CAS  Google Scholar 

  60. Ehsanipour EA, Sheng X, Behan JW, Wang X, Butturini A, Avramis VI, Mittelman SD. Adipocytes cause leukemia cell resistance to L-asparaginase via release of glutamine. Cancer Res. 2013;73(10):2998–3006.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  61. Sheng H, Li P, Chen X, Liu B, Zhu Z, Cao W. Omega-3 PUFAs induce apoptosis of gastric cancer cells via ADORA1. Front Biosci (Landmark Ed). 2014;19:854–61.

    Article  Google Scholar 

  62. Xu Y, Qian SY. Anti-cancer activities of ω-6 polyunsaturated fatty acids. Biomed J. 2014;37(3):112–9.

    PubMed  PubMed Central  Google Scholar 

  63. Zheng H, Tang H, Liu M, He M, Lai P, Dong H, Lin J, Jia C, Zhong M, Dai Y, Bai X, Wang L. Inhibition of endometrial cancer by n-3 polyunsaturated fatty acids in preclinical models. Cancer Prev Res (Phila). 2014;7(8):824–34.

    Article  CAS  Google Scholar 

  64. Takino J, Yamagishi S, Takeuchi M. Cancer malignancy is enhanced by glyceraldehyde-derived advanced glycation end-products. J Oncol. 2010;2010:739852.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  65. Ley RE. Obesity and the human microbiome. Curr Opin Gastroenterol. 2010;26(1):5–11.

    Article  PubMed  Google Scholar 

  66. Thakkar B, Aronis KN, Vamvini MT, Shields K, Mantzoros CS. Metformin and sulfonylureas in relation to cancer risk in type II diabetes patients: a meta-analysis using primary data of published studies. Metabolism. 2013;62(7):922–34.

    Article  PubMed  CAS  Google Scholar 

  67. Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.

    Article  PubMed  Google Scholar 

  68. Birks S, Peeters A, Backholer K, O’Brien P, Brown W. A systematic review of the impact of weight loss on cancer incidence and mortality. Obes Rev. 2012;13(10):868–91.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert W. O’Rourke M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media New York

About this chapter

Cite this chapter

O’Rourke, R.W. (2016). Obesity and Cancer. In: Kurian, M., Wolfe, B., Ikramuddin, S. (eds) Metabolic Syndrome and Diabetes. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3220-7_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-3220-7_8

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-3219-1

  • Online ISBN: 978-1-4939-3220-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics