At least one of every 17 cancers in the U.S. was attributable to excess body weight (EBW), with the District of Columbia and Southern and Midwestern states leading the way, a new study found.
From 2011 to 2015, the population attributable fraction (PAF) of incident cancers due to EBW in adults 30 and up was roughly 10% in women (74,690 cases) and 5% in men (37,670 cases), reported Farhad Islami, MD, PhD, of the American Cancer Society, and colleagues in JAMA Oncology.
“The overall PAF for EBW was higher in women than in men nationally and in all states, largely reflecting the associations of EBW with increased risk for several female-specific cancers,” the researchers explained, listing corpus uteri, breast, and ovarian cancers as some of these drivers.
They also added that nationally, women had a higher prevalence of obesity compared with men (41.1% vs 37.9%, respectively), particularly for class 3 obesity (9.7% vs 5.6%).
PAFs due to EBW varied from state to state, with the highest being in Texas (8.1%), Alaska (7.9%), and Indiana (7.7%) for men and women combined. At 8.3%, however, the District of Columbia had the highest PAF. Hawaii, Colorado, Montana, and Wyoming had the lowest proportion of cases for men and women combined (ranging from 5.9% to 6.3%).
In men specifically, Texas was the state with the highest proportion of cancer cases attributed to excess weight, at 6.0% (95% CI 5.6%-6.4%), and Montana was the state with the lowest proportion, at 3.9% (95% CI 3.6%-4.3%).
As for women, the District of Columbia had the highest PAF, at 11.4% (95% CI 10.7%-12.2%), while Hawaii had the lowest, at 7.1% (95% CI 6.7%-7.6%).
“It is noteworthy that states with relatively low overall cancer incidence rates will have a high PAF for cancer associated with EBW if they have a high EBW prevalence,” Islami’s group explained. “For example, although the overall age-standardized cancer rate in women was higher in Connecticut than in Alaska (526.7 vs 447.7 per 100,000 people in 2010-2014), Connecticut had a lower PAF for cancer associated with EBW than Alaska (8.2% vs 10.4%), reflecting its lower EBW prevalence (adjusted prevalence of 57.7% vs 64.3%, respectively, in 2001-2004).”
For this analysis, the researchers drew upon data from the Behavioral Risk Factor Surveillance System, which included state-by-state BMI information. PAFs for each state were derived from prevalence estimates for the four highest categories of BMI and their associated relative risks for several types of cancers that are associated with EBW as outlined by the International Agency for Research on Cancer. These included esophageal adenocarcinoma, multiple myeloma, and cancers of the gastric cardia, colorectum, liver, gallbladder, pancreas, female breast, corpus uteri, ovary, kidney and renal pelvis, as well as thyroid.
As for addressing this issue, the researchers urged healthcare providers and policymakers, both at the state and federal level, to support efforts to reduce obesity and healthcare disparities that are apparent between states. “Further research to identify tailored and more efficient strategies for reducing the prevalence of EBW is also needed,” they suggested.
The study was supported by the Intramural Research Department of the American Cancer Society.
All study authors are employed by the American Cancer Society, which received a grant from Merck for intramural research outside of the submitted work. The authors’ salaries are solely funded through the American Cancer Society.