Melina Arnold1, Nirmala Pandeya2, Graham Byrnes3, Prof Andrew G Renehan4, Gretchen A Stevens5, Prof Majid Ezzati6,7, Jacques Ferlay1, J Jaime Miranda8, Isabelle Romieu9, Rajesh Dikshit10, David Forman1, Isabelle Soerjomataram1. 1. Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France. 2. School of Population Health, The University of Queensland, Brisbane, Queensland, Australia. 3. Biostatistics Group, International Agency for Research on Cancer, Lyon, France. 4. Faculty Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom. 5. Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland. 6. MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom. 7. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. 8. CRONICAS Centre of Excellence in Chronic Diseases, and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru. 9. Nutrition and Metabolism Section/Epidemiology Group, International Agency for Research on Cancer, Lyon, France. 10. Department of Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Abstract
BACKGROUND: High body-mass index (BMI; defined as 25 kg/m(2) or greater) is associated with increased risk of cancer. To inform public health policy and future research, we estimated the global burden of cancer attributable to high BMI in 2012. METHODS: In this population-based study, we derived population attributable fractions (PAFs) using relative risks and BMI estimates in adults by age, sex, and country. Assuming a 10-year lag-period between high BMI and cancer occurrence, we calculated PAFs using BMI estimates from 2002 and used GLOBOCAN2012 data to estimate numbers of new cancer cases attributable to high BMI. We also calculated the proportion of cancers that were potentially avoidable had populations maintained their mean BMIs recorded in 1982. We did secondary analyses to test the model and to estimate the effects of hormone replacement therapy (HRT) use and smoking. FINDINGS: Worldwide, we estimate that 481,000 or 3.6% of all new cancer cases in adults (aged 30 years and older after the 10-year lag period) in 2012 were attributable to high BMI. PAFs were greater in women than in men (5.4% vs 1.9%). The burden of attributable cases was higher in countries with very high and high human development indices (HDIs; PAF 5.3% and 4.8%, respectively) than in those with moderate (1.6%) and low HDIs (1.0%). Corpus uteri, postmenopausal breast, and colon cancers accounted for 63.6% of cancers attributable to high BMI. A quarter (about 118,000) of the cancer cases related to high BMI in 2012 could be attributed to the increase in BMI since 1982. INTERPRETATION: These findings emphasise the need for a global effort to abate the increasing numbers of people with high BMI. Assuming that the association between high BMI and cancer is causal, the continuation of current patterns of population weight gain will lead to continuing increases in the future burden of cancer. FUNDING: World Cancer Research Fund International, European Commission (Marie Curie Intra-European Fellowship), Australian National Health and Medical Research Council, and US National Institutes of Health.
BACKGROUND: High body-mass index (BMI; defined as 25 kg/m(2) or greater) is associated with increased risk of cancer. To inform public health policy and future research, we estimated the global burden of cancer attributable to high BMI in 2012. METHODS: In this population-based study, we derived population attributable fractions (PAFs) using relative risks and BMI estimates in adults by age, sex, and country. Assuming a 10-year lag-period between high BMI and cancer occurrence, we calculated PAFs using BMI estimates from 2002 and used GLOBOCAN2012 data to estimate numbers of new cancer cases attributable to high BMI. We also calculated the proportion of cancers that were potentially avoidable had populations maintained their mean BMIs recorded in 1982. We did secondary analyses to test the model and to estimate the effects of hormone replacement therapy (HRT) use and smoking. FINDINGS: Worldwide, we estimate that 481,000 or 3.6% of all new cancer cases in adults (aged 30 years and older after the 10-year lag period) in 2012 were attributable to high BMI. PAFs were greater in women than in men (5.4% vs 1.9%). The burden of attributable cases was higher in countries with very high and high human development indices (HDIs; PAF 5.3% and 4.8%, respectively) than in those with moderate (1.6%) and low HDIs (1.0%). Corpus uteri, postmenopausal breast, and colon cancers accounted for 63.6% of cancers attributable to high BMI. A quarter (about 118,000) of the cancer cases related to high BMI in 2012 could be attributed to the increase in BMI since 1982. INTERPRETATION: These findings emphasise the need for a global effort to abate the increasing numbers of people with high BMI. Assuming that the association between high BMI and cancer is causal, the continuation of current patterns of population weight gain will lead to continuing increases in the future burden of cancer. FUNDING: World Cancer Research Fund International, European Commission (Marie Curie Intra-European Fellowship), Australian National Health and Medical Research Council, and US National Institutes of Health.
Authors: Annika Steffen; Matthias B Schulze; Tobias Pischon; Thomas Dietrich; Esther Molina; Maria-Dolores Chirlaque; Aurelio Barricarte; Pilar Amiano; J Ramón Quirós; Rosario Tumino; Amalia Mattiello; Domenico Palli; Paolo Vineis; Claudia Agnoli; Gesthimani Misirli; Paolo Boffetta; Rudolf Kaaks; Sabine Rohrmann; H Bas Bueno-de-Mesquita; Petra H M Peeters; Anne M May; Elizabeth A Spencer; Naomi E Allen; Sheila Bingham; Anne Tjønneland; Jytte Halkjaer; Kim Overvad; Jakob Stegger; Jonas Manjer; Björn Lindkvist; Göran Hallmanns; Roger Stenling; Eiliv Lund; Elio Riboli; Carlos A Gonzalez; Heiner Boeing Journal: Cancer Epidemiol Biomarkers Prev Date: 2009-06-30 Impact factor: 4.254
Authors: Juhua Luo; Kimberly Horn; Judith K Ockene; Michael S Simon; Marcia L Stefanick; Elisa Tong; Karen L Margolis Journal: Am J Epidemiol Date: 2011-08-29 Impact factor: 4.897
Authors: Stephen S Lim; Theo Vos; Abraham D Flaxman; Goodarz Danaei; Kenji Shibuya; Heather Adair-Rohani; Markus Amann; H Ross Anderson; Kathryn G Andrews; Martin Aryee; Charles Atkinson; Loraine J Bacchus; Adil N Bahalim; Kalpana Balakrishnan; John Balmes; Suzanne Barker-Collo; Amanda Baxter; Michelle L Bell; Jed D Blore; Fiona Blyth; Carissa Bonner; Guilherme Borges; Rupert Bourne; Michel Boussinesq; Michael Brauer; Peter Brooks; Nigel G Bruce; Bert Brunekreef; Claire Bryan-Hancock; Chiara Bucello; Rachelle Buchbinder; Fiona Bull; Richard T Burnett; Tim E Byers; Bianca Calabria; Jonathan Carapetis; Emily Carnahan; Zoe Chafe; Fiona Charlson; Honglei Chen; Jian Shen Chen; Andrew Tai-Ann Cheng; Jennifer Christine Child; Aaron Cohen; K Ellicott Colson; Benjamin C Cowie; Sarah Darby; Susan Darling; Adrian Davis; Louisa Degenhardt; Frank Dentener; Don C Des Jarlais; Karen Devries; Mukesh Dherani; Eric L Ding; E Ray Dorsey; Tim Driscoll; Karen Edmond; Suad Eltahir Ali; Rebecca E Engell; Patricia J Erwin; Saman Fahimi; Gail Falder; Farshad Farzadfar; Alize Ferrari; Mariel M Finucane; Seth Flaxman; Francis Gerry R Fowkes; Greg Freedman; Michael K Freeman; Emmanuela Gakidou; Santu Ghosh; Edward Giovannucci; Gerhard Gmel; Kathryn Graham; Rebecca Grainger; Bridget Grant; David Gunnell; Hialy R Gutierrez; Wayne Hall; Hans W Hoek; Anthony Hogan; H Dean Hosgood; Damian Hoy; Howard Hu; Bryan J Hubbell; Sally J Hutchings; Sydney E Ibeanusi; Gemma L Jacklyn; Rashmi Jasrasaria; Jost B Jonas; Haidong Kan; John A Kanis; Nicholas Kassebaum; Norito Kawakami; Young-Ho Khang; Shahab Khatibzadeh; Jon-Paul Khoo; Cindy Kok; Francine Laden; Ratilal Lalloo; Qing Lan; Tim Lathlean; Janet L Leasher; James Leigh; Yang Li; John Kent Lin; Steven E Lipshultz; Stephanie London; Rafael Lozano; Yuan Lu; Joelle Mak; Reza Malekzadeh; Leslie Mallinger; Wagner Marcenes; Lyn March; Robin Marks; Randall Martin; Paul McGale; John McGrath; Sumi Mehta; George A Mensah; Tony R Merriman; Renata Micha; Catherine Michaud; Vinod Mishra; Khayriyyah Mohd Hanafiah; Ali A Mokdad; Lidia Morawska; Dariush Mozaffarian; Tasha Murphy; Mohsen Naghavi; Bruce Neal; Paul K Nelson; Joan Miquel Nolla; Rosana Norman; Casey Olives; Saad B Omer; Jessica Orchard; Richard Osborne; Bart Ostro; Andrew Page; Kiran D Pandey; Charles D H Parry; Erin Passmore; Jayadeep Patra; Neil Pearce; Pamela M Pelizzari; Max Petzold; Michael R Phillips; Dan Pope; C Arden Pope; John Powles; Mayuree Rao; Homie Razavi; Eva A Rehfuess; Jürgen T Rehm; Beate Ritz; Frederick P Rivara; Thomas Roberts; Carolyn Robinson; Jose A Rodriguez-Portales; Isabelle Romieu; Robin Room; Lisa C Rosenfeld; Ananya Roy; Lesley Rushton; Joshua A Salomon; Uchechukwu Sampson; Lidia Sanchez-Riera; Ella Sanman; Amir Sapkota; Soraya Seedat; Peilin Shi; Kevin Shield; Rupak Shivakoti; Gitanjali M Singh; David A Sleet; Emma Smith; Kirk R Smith; Nicolas J C Stapelberg; Kyle Steenland; Heidi Stöckl; Lars Jacob Stovner; Kurt Straif; Lahn Straney; George D Thurston; Jimmy H Tran; Rita Van Dingenen; Aaron van Donkelaar; J Lennert Veerman; Lakshmi Vijayakumar; Robert Weintraub; Myrna M Weissman; Richard A White; Harvey Whiteford; Steven T Wiersma; James D Wilkinson; Hywel C Williams; Warwick Williams; Nicholas Wilson; Anthony D Woolf; Paul Yip; Jan M Zielinski; Alan D Lopez; Christopher J L Murray; Majid Ezzati; Mohammad A AlMazroa; Ziad A Memish Journal: Lancet Date: 2012-12-15 Impact factor: 79.321
Authors: Joannie Lortet-Tieulent; Elisenda Renteria; Linda Sharp; Elisabete Weiderpass; Harry Comber; Paul Baas; Freddie Bray; Jan Willem Coebergh; Isabelle Soerjomataram Journal: Eur J Cancer Date: 2013-11-20 Impact factor: 9.162
Authors: Jacques Ferlay; Isabelle Soerjomataram; Rajesh Dikshit; Sultan Eser; Colin Mathers; Marise Rebelo; Donald Maxwell Parkin; David Forman; Freddie Bray Journal: Int J Cancer Date: 2014-10-09 Impact factor: 7.396
Authors: D C Whiteman; S Sadeghi; N Pandeya; B M Smithers; D C Gotley; C J Bain; P M Webb; A C Green Journal: Gut Date: 2007-10-11 Impact factor: 23.059
Authors: Alison Fildes; Judith Charlton; Caroline Rudisill; Peter Littlejohns; Toby Prevost; Martin C Gulliford Journal: Am J Public Health Date: 2015-09-17 Impact factor: 9.308
Authors: José Baselga; Nina Bhardwaj; Lewis C Cantley; Ronald DeMatteo; Raymond N DuBois; Margaret Foti; Susan M Gapstur; William C Hahn; Lee J Helman; Roy A Jensen; Electra D Paskett; Theodore S Lawrence; Stuart G Lutzker; Eva Szabo Journal: Clin Cancer Res Date: 2015-10-01 Impact factor: 12.531
Authors: Gertraud Maskarinec; Simone Jacobs; Song-Yi Park; Christopher A Haiman; Veronica W Setiawan; Lynne R Wilkens; Loïc Le Marchand Journal: Cancer Epidemiol Biomarkers Prev Date: 2017-01-13 Impact factor: 4.254
Authors: Alison L Van Dyke; Meredith S Shiels; Gieira S Jones; Ruth M Pfeiffer; Jessica L Petrick; Jennifer L Beebe-Dimmer; Jill Koshiol Journal: Cancer Date: 2019-01-15 Impact factor: 6.860
Authors: Ruby Fore; Jaime E Hart; Christine Choirat; Jennifer W Thompson; Kathleen Lynch; Francine Laden; Jorge E Chavarro; Peter James Journal: Cancer Epidemiol Biomarkers Prev Date: 2020-02-25 Impact factor: 4.254
Authors: Melina Arnold; Amy Colquhoun; Michael B Cook; Jacques Ferlay; David Forman; Isabelle Soerjomataram Journal: Cancer Epidemiol Biomarkers Prev Date: 2015-10-22 Impact factor: 4.254