Gender Differences in Obesity-Related Cancers

Abstract

Purpose of review

In this review, we summarize the role of obesity in carcinogenesis, providing details on specific cancer sites. Special emphasis is given to gender differences in obesity-related cancers and on the effect of bariatric surgery on cancer risk.

Recent Findings

Accumulating evidence has highlighted the detrimental role of overweight/obesity in cancer, with almost 55% of cancers diagnosed in women and 24% diagnosed in men considered overweight- and obesity-related cancers. Sufficient data have shown that higher BMI is associated with risk of gynecologic malignancies (mainly breast and endometrial cancers) as well as cancers in sites such as the esophagus (adenocarcinoma), gastric cardia, colon, rectum, liver, gallbladder, pancreas, kidney, thyroid gland, and multiple myeloma. The main mechanisms underlying this relationship include the insulin/IGF1 system, the effect of sex hormones, and adipocytokines. Marked differences may be seen in specific cancer sites when comparing men to women. There is a higher overall incidence of obesity-related cancers among females (endometrial, ovarian, and postmenopausal female breast cancers), whereas cancers that concern both sexes show a higher incidence in males, particularly esophageal adenocarcinoma (male to female ratio: 9: 1 in the USA). Additionally, bariatric surgery has provided evidence of lowering overall cancer risk in patients with morbid obesity. Interestingly, bariatric surgery may lower overall cancer risk in women within the first 5 years after surgery due to the reduced risk of breast and endometrial cancer, and non-Hodgkin lymphoma.

Summary

Obesity constitutes the base for marked metabolic, hormonal, and inflammatory alterations, including increased cancer risk in both men and women. Implementation of early obesity prevention strategies could ameliorate the continuously increasing incidence of cancer attributed to obesity.

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Fig. 1

Abbreviations

AMP:

adenosine monophosphate

BMI:

body mass index

DLBCL:

diffuse large B cell lymphoma

DM:

diabetes mellitus

CUP:

continuous update project

ER:

estrogen receptor

ERK:

extracellular signal regulated kinase

ERBB2:

Erb-B2 receptor tyrosine kinase 2

HCC:

hepatocellular cancer

HER2:

human epidermal growth factor receptor 2

HR:

hormone receptors

HRT:

hormone replacement therapy

HIF:

hypoxia inducible factor

IARC:

International Agency for Research on Cancer

IL:

interleukin

IGF:

insulin-like growth factor

JAK/STAT:

Janus kinases/signal transducer and activator of transcription protein

MAPK:

mitogen-activated protein kinase

NAFLD:

non-alcoholic fatty liver disease

NSCLC:

non-small cell lung cancer

NF-kB:

nuclear factor-kB

PAF:

population attributable fraction

PI3K/AKT:

phosphatidylinositol 3 kinase/protein kinase B

RYGB:

Roux-en-y gastric bypass

SHBG:

sex hormone binding globulin

PR:

progesteron receptor

TLR-4:

toll-like receptor-4

TNF-α:

tumor necrosis factor-α

TSH:

thyroid-stimulating hormone

VEGF:

vascular endothelial growth factor

WC:

waist circumference

WCRF:

World Cancer Research Fund

WCRF/AICR:

World Cancer Research Fund/American Institute for Cancer Research

WHR:

waist-to-hip ratio

WHO:

World Health Organization

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Acknowledgements

We wish to express our deepest thanks to Katerina Sotiropoulou for kindly designing Fig. 1.

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Argyrakopoulou, G., Dalamaga, M., Spyrou, N. et al. Gender Differences in Obesity-Related Cancers. Curr Obes Rep (2021). https://doi.org/10.1007/s13679-021-00426-0

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Keywords

  • Adipokine
  • Bariatric
  • Breast cancer
  • Cancer
  • Estrogen
  • Gender
  • Obesity
  • Sex