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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
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
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
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
Renehan AG, Zwahlen M, Egger M (2015) Adiposity and cancer risk: new mechanistic insights from epidemiology. Nat Rev Cancer 15:484–498
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
Song M, Giovannucci E (2016) Estimating the Influence of obesity on cancer risk: stratification by smoking is critical. J Clin Oncol 34:3237–3239
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
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
Repace J (2002) Right to life overrides right to smoke. Feb 20. Irish Times
Howell F (2004) Ireland’s workplaces, going smoke free. BMJ 328:847–848
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
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
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
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
Renehan AG, MacKintosh ML, Crosbie EJ (2016) Obesity and endometrial cancer: unanswered epidemiological questions. BJOG 123:175–178
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
Levin ML (1953) The occurrence of lung cancer in man. Acta Unio Int Contra Cancrum 9:531–541
Flegal KM, Graubard BI, Williamson DF (2004) Methods of calculating deaths attributable to obesity. Am J Epidemiol 160:331–338
Barendregt JJ, Veerman JL (2010) Categorical versus continuous risk factors and the calculation of potential impact fractions. J Epidemiol Community Health 64:209–212
Hanley JA (2001) A heuristic approach to the formulas for population attributable fraction. J Epidemiol Community Health 55:508–514
Maldonado G, Greenland S (2002) Estimating causal effects. Int J Epidemiol 31:422–429
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
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
Pischon T, Nimptsch K, Obesity and risk of cancer: an introductory overview [in this Special Issue]. Recent Results Cancer Res (in press)
Renehan AG, Egger M, Zwahlen M (2010) Body mass index and cancer risk: the evidence for causal association. BMC Open J Obes
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
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)
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
Doll R, Peto R, Boreham J, Sutherland I (2004) Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 328:1519
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
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
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
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
Renehan AG (2009) Bariatric surgery, weight reduction and cancer prevention. Lancet Oncol 10:640–641
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
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
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
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
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
Bray F, Moller B (2006) Predicting the future burden of cancer. Nat Rev Cancer 6:63–74
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
Dyba T, Hakulinen T (2008) Do cancer predictions work? Eur J Cancer 44:448–453
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
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
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights 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)