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Proportion of new cancers attributable to excess weight varies across states
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Excess body weight is responsible for at least one in 17 new cancers in each state in the U.S., according to a study published in JAMA Oncology.
“We recently showed that 7.8% of all cancers among adults 30 years and older in 2014 were attributable to excess body weight, with a higher burden among women,” Farhad Islami, MD, PhD, strategic director of cancer surveillance research at American Cancer Society, and colleagues wrote. “To our knowledge, however, only one modeling study has estimated the population attributable fraction for excess body weight-related cancer by state, despite substantial variations in excess body weight-related prevalence across states.”
In the nationwide, cross-sectional study, Islami and colleagues assessed state-level, self-reported BMI data from the Behavioral Risk Factor Surveillance System, which they adjusted by sex, age, race/ethnicity and education with objectively measured BMI data from the National Health and Nutrition Examination Survey.
The researchers calculated the population attributable fraction of 13 types of invasive cancers — esophageal adenocarcinoma, multiple myeloma, and cancers of the gastric cardia, colorectum, liver, gallbladder, pancreas, breast (female), corpus uteri, ovary, kidney and renal pelvis, and thyroid.
— for each state using sex-, age- and state-specific adjusted prevalence estimates for four high BMI categories.
Results showed that among U.S. adults aged 30 years or older, excess body weight accounted for an estimated 37,670 cancer cases in men (4.7% of all cases, excluding nonmelanoma skin cancers) and 74,790 cases in women (9.6%) from 2011 to 2015.
Researchers reported a 1.5-fold difference overall in the percentages of cancers owing to excess body weight between states with the highest and lowest population attributable fractions.
Among men, the population attributable factors ranged from 3.9% (95% CI, 3.6-4.3) in Montana to 6% (95% CI, 5.6-6.4) in Texas. Women had roughly double the population attributable fraction observed in men, ranging from 7.1% (95% CI, 6.7-7.6) in Hawaii to 11.4% (95% CI, 10.7-12.2) in Washington, D.C.
Various southern and Midwestern states, Alaska and Washington, D.C., had the highest population attributable fractions, whereas Nevada, Wyoming, Montana, Colorado, Hawaii and New England states had the lowest fractions.
Among all states, at least 25% of esophageal, liver and gallbladder, kidney and renal pelvis, and corpus uteri cancers were attributable to excess body weight. The population attributable fraction for corpus uteri cancer was 50% or more in 19 states.
Study limitations included the fact that proportions for some cancer types in less-populated states were based on a small number of cases.
“Increases in obesity prevalence over the past 40 years strongly suggest that the burden of excess body weight will further increase in the decades to come,” the researchers wrote. “Broad implementation of known community- and individual-level interventions is needed to reduce access to and marketing of unhealthy foods (eg, through a tax on sugary drinks) and to promote and increase access to healthy foods and physical activity, as well as preventive care.” – by Jennifer Byrne
Disclosures: The study was supported by the Intramural Research Department of the American Cancer Society. All researchers report being employment with American Cancer Society.
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