Obesity and Cancer: What Is the Connection, and What Is the Path Forward?

THE QUESTION ABOUT OBESITY is no longer whether or not it contributes to the development of cancer, but how much, and in whom. Most importantly, our question should be: What are we going to do about it?

Epidemiological studies, as well as data from large prospective trials, have repeatedly shown that obesity increases the risk of certain cancers — some more than others — and, interestingly, for many cancers, appears to do so more in women than in men. For some cancers like endometrial, post-menopausal breast and, most impressively, gastro-esophageal and liver cancers, the impact is strong enough to be associated with trends in the rates of these cancers that mirror the trajectory of the obesity epidemic in the United States.

In this issue of CURE®, you will learn about the biology that links obesity, inflammation and cancer. We may be finally seeing the very beginning of a leveling off of obesity, even though the rates are still rising. But we actually need to reverse the trend, and also to recognize the asymmetric distribution of obesity in geographic areas and by ethnic, educational and socioeconomic factors.

Declines already witnessed in smoking rates and tobacco-related illnesses were the products of aggressive education, social consciousness, media coverage and, ultimately, legislation. The same roadmap, perhaps with a few revisions and innovations, could also turn the tide in our waistlines. Even though Americans tend not to like the nanny approach, there are some policy changes, coupled with well-designed campaigns, that could make a difference. One example has been changes in zoning rules and several nonprofit and corporate initiatives that have allowed for the creation of urban gardens and cooperatives that produce fresh fruits and vegetables in “food deserts,” which tend to exist in depressed areas of cities. These provide healthy options where they are needed the most. Similarly, the development of recreational spaces and the integration of physical activity into school and work environments is a trend that has started and certainly can be augmented.

The most important component is simply awareness and education surrounding the scope and effects of obesity — and simple steps that can become lifestyle changes and can last a lifetime. We ask that you not only read our feature article, but that you pass it on to your loved ones, acquaintances and colleagues — not only for their sakes, but for our collective health.

DEBU TRIPATHY, M.D.Editor-in-ChiefProfessor of MedicineChair, Department of Breast Medical OncologyThe University of Texas MD Anderson Cancer Center