Skip to main content

Obesity as an Avoidable Cause of Cancer (Attributable Risks)

Part of the Recent Results in Cancer Research book series (RECENTCANCER,volume 208)

Abstract

Excess body weight, commonly categorised as overweight (body mass index, BMI 25.0–29.9 kg/m2) and obesity (BMI ≥30 kg/m2) is an established risk factor for increased incidence of several adult cancers. As body weight is modifiable, there is a potential for cancer prevention. Calculation of attributable risk (here expressed at population attributable fraction, PAF) offers an estimate of the burden of excess cancers attributable to elevated BMI in populations, and thus an approximation of avoidable cases and the opportunity for prevention. Using counterfactual methods, the estimated PAF worldwide attributed to elevated BMI is 3.6 % or nearly half a million new cancer cases in adults (aged 30 years and older after a 10-year lag period). PAFs are higher in women compared with men (5.4 % vs. 1.9 %). Endometrial, post-menopausal breast, and colon cancers account for nearly two-thirds of cancers attributable to elevated BMI. Globally, excess body weight is the third commonest attributable risk factor for cancer (after smoking and infection); in western populations such as the UK, excess weight ranks as second commonest risk factor.

Keywords

  • Population attributable fraction
  • Burden of disease
  • Avoidable cancers
  • Cancer prevention

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-319-42542-9_13
  • Chapter length: 14 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   109.00
Price excludes VAT (USA)
  • ISBN: 978-3-319-42542-9
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   139.99
Price excludes VAT (USA)
Hardcover Book
USD   199.99
Price excludes VAT (USA)
Fig. 1

References

  1. Renehan A, Tyson M, Egger M, Heller RF, Zwahlen M (2008) Body mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371:569–578

    CrossRef  PubMed  Google Scholar 

  2. Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K (2016) Body fatness and cancer-viewpoint of the IARC Working Group. N Engl J Med 375:794–798

    CrossRef  PubMed  Google Scholar 

  3. World Cancer Research Fund. Weight and cancer http://www.wcrf.org/int/cancer-facts-figures/link-between-lifestyle-cancer-risk/weight-cancer. Accessed 8 Aug 2016

  4. Renehan AG, Zwahlen M, Egger M (2015) Adiposity and cancer risk: new mechanistic insights from epidemiology. Nat Rev Cancer 15:484–498

    CAS  CrossRef  PubMed  Google Scholar 

  5. Park J, Morley TS, Kim M, Clegg DJ, Scherer PE (2014) Obesity and cancer–mechanisms underlying tumour progression and recurrence. Nat Rev Endocrinol 10:455–465

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  6. Song M, Giovannucci E (2016) Estimating the Influence of obesity on cancer risk: stratification by smoking is critical. J Clin Oncol 34:3237–3239

    Google Scholar 

  7. Renehan AG, Soerjomataram I, Leitzmann MF (2010) Interpreting the epidemiological evidence linking obesity and cancer: a framework for population-attributable risk estimations in Europe. Eur J Cancer 46:2581–2592

    CrossRef  PubMed  Google Scholar 

  8. Aune D, Greenwood DC, Chan DS, Vieira R, Vieira AR, Navarro Rosenblatt DA et al (2012) Body mass index, abdominal fatness and pancreatic cancer risk: a systematic review and non-linear dose-response meta-analysis of prospective studies. Ann Oncol (Official Journal of the European Society for Medical Oncology/ESMO) 23:843–852

    CAS  CrossRef  Google Scholar 

  9. Repace J (2002) Right to life overrides right to smoke. Feb 20. Irish Times

    Google Scholar 

  10. Howell F (2004) Ireland’s workplaces, going smoke free. BMJ 328:847–848

    CrossRef  PubMed  PubMed Central  Google Scholar 

  11. Imamura F, O’Connor L, Ye Z, Mursu J, Hayashino Y, Bhupathiraju SN et al (2015) Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ 351:h3576

    CrossRef  PubMed  PubMed Central  Google Scholar 

  12. Singh GM, Micha R, Khatibzadeh S, Lim S, Ezzati M, Mozaffarian D et al (2015) Estimated global, regional, and national disease burdens related to sugar-sweetened beverage consumption in 2010. Circulation 132:639–666

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  13. Cancer Research UK/UK Health Forum: Tipping the scales: why preventing obesity makes scene https://www.cancerresearchuk.org/sites/default/files/tipping_the_scales_-_cruk_full_report1.pdf2016

  14. Renehan AG, Soerjomataram I, Tyson M, Egger M, Zwahlen M, Coebergh JW et al (2010) Incident cancer burden attributable to excess body mass index in 30 European countries. Int J Cancer 126:692–702

    CAS  CrossRef  PubMed  Google Scholar 

  15. Renehan AG, MacKintosh ML, Crosbie EJ (2016) Obesity and endometrial cancer: unanswered epidemiological questions. BJOG 123:175–178

    Google Scholar 

  16. Menvielle G, Soerjomataram I, de Vries E, Engholm G, Barendregt JJ, Coebergh JW et al (2010) Scenarios of future lung cancer incidence by educational level: modelling study in Denmark. Eur J Cancer 46:2625–2632

    CrossRef  PubMed  Google Scholar 

  17. Levin ML (1953) The occurrence of lung cancer in man. Acta Unio Int Contra Cancrum 9:531–541

    CAS  PubMed  Google Scholar 

  18. Flegal KM, Graubard BI, Williamson DF (2004) Methods of calculating deaths attributable to obesity. Am J Epidemiol 160:331–338

    CrossRef  PubMed  Google Scholar 

  19. Barendregt JJ, Veerman JL (2010) Categorical versus continuous risk factors and the calculation of potential impact fractions. J Epidemiol Community Health 64:209–212

    CrossRef  PubMed  Google Scholar 

  20. Hanley JA (2001) A heuristic approach to the formulas for population attributable fraction. J Epidemiol Community Health 55:508–514

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  21. Maldonado G, Greenland S (2002) Estimating causal effects. Int J Epidemiol 31:422–429

    CrossRef  PubMed  Google Scholar 

  22. James WPT, Jackson-Leach R, Mhurchu AN (2004) Overweight and obesity (high body mass index). In: Ezzati M, Lopez AD, Rodgers A, Murray CJL (eds) Comparative quantification of health risks. World Health Organization, Geneva, pp 497–596

    Google Scholar 

  23. Arnold M, Pandeya N, Byrnes G, Renehan AG, Stevens GA, Ezzati M et al (2015) Global burden of cancer attributable to high body-mass index in 2012: a population-based study. Lancet Oncol 16:36–46

    CrossRef  PubMed  Google Scholar 

  24. Pischon T, Nimptsch K, Obesity and risk of cancer: an introductory overview [in this Special Issue]. Recent Results Cancer Res (in press)

    Google Scholar 

  25. Renehan AG, Egger M, Zwahlen M (2010) Body mass index and cancer risk: the evidence for causal association. BMC Open J Obes

    Google Scholar 

  26. Lawlor DA, Davey Smith G, Kundu D, Bruckdorfer KR, Ebrahim S (2004) Those confounded vitamins: what can we learn from the differences between observational versus randomised trial evidence? Lancet 363:1724–1727

    Google Scholar 

  27. Sperrin M, Marshall AD, Higgins V, Buchan IE, Renehan AG (2013) Slowing down of adult body mass index trend increases in England: a latent class analysis of cross-sectional surveys (1992–2010). Int J Obes (Lond)

    Google Scholar 

  28. Crosbie EJ, Zwahlen M, Kitchener HC, Egger M, Renehan AG (2010) Body mass index, hormone replacement therapy, and endometrial cancer risk: a meta-analysis. Cancer Epidemiol Biomark Prev 19:3119–3130

    CAS  CrossRef  Google Scholar 

  29. Doll R, Peto R, Boreham J, Sutherland I (2004) Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 328:1519

    CrossRef  PubMed  PubMed Central  Google Scholar 

  30. Williamson DF, Pamuk E, Thun M, Flanders D, Byers T, Heath C (1999) Prospective study of intentional weight loss and mortality in overweight white men aged 40–64 years. Am J Epidemiol 149:491–503

    CAS  CrossRef  PubMed  Google Scholar 

  31. Arnold M, Freisling H, Stolzenberg-Solomon R, Kee F, O’Doherty MG, Ordonez-Mena JM et al (2016) Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States. Eur J Epidemiol 31:893–904

    CrossRef  PubMed  Google Scholar 

  32. Arnold M, Jiang L, Stefanick ML, Johnson KC, Lane DS, LeBlanc ES et al (2016) Duration of adulthood overweight, obesity, and cancer risk in the Women’s health initiative: a longitudinal study from the United States. PLoS Med 13:e1002081

    CrossRef  PubMed  PubMed Central  Google Scholar 

  33. Meza R, Jeon J, Renehan AG, Luebeck EG (2010) Colorectal cancer incidence trends in the United States and United Kingdom: evidence of right- to left-sided biological gradients with implications for screening. Cancer Res 70:5419–5429

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  34. Renehan AG (2009) Bariatric surgery, weight reduction and cancer prevention. Lancet Oncol 10:640–641

    CrossRef  PubMed  Google Scholar 

  35. Arnold M, Leitzmann M, Freisling H, Bray F, Romieu I, Renehan A et al (2016) Obesity and cancer: an update of the global impact. Cancer Epidemiol 41:8–15

    CrossRef  PubMed  Google Scholar 

  36. Ezzati M, Henley SJ, Lopez AD, Thun MJ (2005) Role of smoking in global and regional cancer epidemiology: current patterns and data needs. Int J Cancer 116:963–971

    CAS  CrossRef  PubMed  Google Scholar 

  37. de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D et al (2012) Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol 13:607–615

    CrossRef  PubMed  Google Scholar 

  38. Parkin DM, Boyd L, Walker LC (2011) The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Br J Cancer 105(Suppl 2):S77–S81

    CrossRef  PubMed  PubMed Central  Google Scholar 

  39. Whiteman DC, Webb PM, Green AC, Neale RE, Fritschi L, Bain CJ et al (2015) Cancers in Australia in 2010 attributable to modifiable factors: summary and conclusions. Aust NZ J Public Health 39:477–484

    CrossRef  Google Scholar 

  40. Bray F, Moller B (2006) Predicting the future burden of cancer. Nat Rev Cancer 6:63–74

    CAS  CrossRef  PubMed  Google Scholar 

  41. Bray F, Jemal A, Grey N, Ferlay J, Forman D (2012) Global cancer transitions according to the human development index (2008–2030): a population-based study. Lancet Oncol 13:790–801

    CrossRef  PubMed  Google Scholar 

  42. Dyba T, Hakulinen T (2008) Do cancer predictions work? Eur J Cancer 44:448–453

    Google Scholar 

  43. Soerjomataram I, de Vries E, Engholm G, Paludan-Muller G, Bronnum-Hansen H, Storm HH et al (2010) Impact of a smoking and alcohol intervention programme on lung and breast cancer incidence in Denmark: an example of dynamic modelling with prevent. Eur J Cancer 46:2617–2624

    CrossRef  PubMed  Google Scholar 

  44. de Vries E, Soerjomataram I, Lemmens VE, Coebergh JW, Barendregt JJ, Oenema A et al (2010) Lifestyle changes and reduction of colon cancer incidence in Europe: a scenario study of physical activity promotion and weight reduction. Eur J Cancer 46:2605–2616

    CrossRef  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrew G. Renehan .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Renehan, A.G., Soerjomataram, I. (2016). Obesity as an Avoidable Cause of Cancer (Attributable Risks). In: Pischon, T., Nimptsch, K. (eds) Obesity and Cancer. Recent Results in Cancer Research, vol 208. Springer, Cham. https://doi.org/10.1007/978-3-319-42542-9_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-42542-9_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42540-5

  • Online ISBN: 978-3-319-42542-9

  • eBook Packages: MedicineMedicine (R0)