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Weight linked to more cancer deaths than previously thought
Source: (cancerfacts.com)
Thursday, April 24, 2003
ATLANTA – April 24, 2003 – Overweight and obese people face a much higher risk of dying of cancer than their counterparts who are not overweight, according to a massive 16-year study by the American Cancer Society.
The research team led by Dr. Eugenia Calle of the American Cancer Society estimates that being overweight or obese may account for 20 percent of all cancer deaths in United States women and 14 percent in men. That translates to 90,000 cancer deaths each year that may be attributed to unhealthy excess body weight. The new study was published today in the New England Journal of Medicine.
"As a society, we have not really acknowledged the contribution of obesity to chronic disease in general and cancer in particular," Calle said in a report on the ACS Web site. "We are not taking it seriously enough to turn it around. We are not acting on it."
The 900,000 (404,576 men and 495,477 women) people in this study were selected from nearly 1.2 million participants in the Cancer Prevention Study II, a study begun by the American Cancer Society in 1982. The participants were identified and enrolled by more than 77,000 volunteers in all 50 states, the District of Columbia and Puerto Rico.
They compared participants based on their body mass index, or BMI, a measure of weight adjusted for height. People with a BMI between 25 and 29.9 are considered overweight; those with a BMI of 30 or more are considered obese. People with a BMI between 18.5 and 24.9 are considered normal weight.
Calle and her colleagues found that the heaviest men in the study had death rates from all cancers combined that were 52 percent higher than the rates among normal-weight men. The heaviest women had cancer death rates 62 percent higher than normal-weight women.
Their work also confirmed previous studies that linked being overweight or obese to cancers of the uterus, kidney, esophagus, gallbladder, colon and rectum, and breast (in postmenopausal women).
The effects on breast cancer are compounded because obesity increases a woman's risk of developing the disease in the first place, and her risk of dying from it once she has it, Calle said.
The researchers also found that many types of cancer that were not previously linked to obesity were also affected by excess body weight. These included cancers of the liver, pancreas, prostate, cervix, ovary, and stomach (in men), as well as non-Hodgkin lymphoma and multiple myeloma.
Just how excess weight can lead to cancer is not known, however, researchers theorize that obesity acts on cancer by raising the body's levels of hormones. Sex hormones like estrogen, or protein hormones like insulin, and insulin-related growth factors have been linked to a variety of cancers. Too much fat around the waist, for instance, can disrupt insulin metabolism and increase the risk for colon cancer, among others, according to Calle, who is director of analytic epidemiology at the American Cancer Society.
In the year 2000, about 65 percent of US adults were overweight or obese, according to the Centers for Disease Control and Prevention, and about 31 percent were obese. The American Cancer Society recommends balancing calorie intake with physical activity by eating at least five servings of fruit and vegetables every day, choosing whole grains over processed grains, and limiting red meat. Adults should engage in at least 30 minutes of moderate physical activity five days a week or more.
SOURCE: New England Journal of Medicine; Vol. 348, No. 17: 1625-1638
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