Obesity as an avoidable cause of cancer (attributable risks).

Abstract

Excess body weight, commonly categorised as overweight (body mass index, BMI 25.0-29.9 kg/m(2)) and obesity (BMI ≥30 kg/m(2)) 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.