Intended for healthcare professionals

Practice ABC of obesity

Obesity and cancer

BMJ 2006; 333 doi: (Published 23 November 2006) Cite this as: BMJ 2006;333:1109
  1. Donald C McMillan, senior lecturer1,
  2. Naveed Sattar, professor of metabolic medicine2,
  3. Mike Lean, professor of nutrition2,
  4. Colin S McArdle, honorary professor1
  1. 1university department of surgery at the Royal Infirmary, Glasgow
  2. 2University of Glasgow

    Incidence and mortality

    View this table:

    Percentage of cancer cases attributable to overweight and obesity in countries of the European Union, by cancer site. Adapted from Bergstrom et al (see Further Reading box)

    Obesity is increasing at an alarming rate throughout North America and Europe and is associated with substantial morbidity and mortality. The condition has long been recognised as a risk factor for diabetes and cardiovascular disease, but not for developing cancer. A recent survey of the public by the American Cancer Society found that less than 5% of respondents were aware of the increased cancer risk associated with overweight and obesity.

    Contribution of overweight and obesity to mortality from cancer in the United States, 1982-98. Adapted from Adami H-O et al (N Engl J Med 2003;348:1623-4)

    A recent meta-analysis showed that more than 70 000 of the 3.5 million new cases of cancer each year in the European Union are attributable to overweight or obesity. This is likely to be a conservative estimate for two reasons. Firstly, only those tumours for which there was existing evidence to suggest a link between obesity and cancer (namely, for breast, colon, endometrium, prostate, kidney, and gallbladder) were included in the study. Secondly, the number of cancers attributable to obesity is likely to have increased because obesity levels have increased substantially since the publication of many of the studies included in this meta-analysis.

    More recently, the American Cancer Society's prospective population based study of about 900 000 subjects confirmed that obesity was directly associated with an increased risk of death from a variety of cancers.

    Mortality from cancer for US men, 1982-98, by body mass index (BMI). For each relative risk, the comparison was between men in the highest BMI category and men in the reference category (18.5 to 24.9). Adapted from Calle et al (see Further Reading …

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