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.
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.
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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body mass index
diffuse large B cell lymphoma
continuous update project
extracellular signal regulated kinase
Erb-B2 receptor tyrosine kinase 2
human epidermal growth factor receptor 2
hormone replacement therapy
hypoxia inducible factor
International Agency for Research on Cancer
insulin-like growth factor
Janus kinases/signal transducer and activator of transcription protein
mitogen-activated protein kinase
non-alcoholic fatty liver disease
non-small cell lung cancer
population attributable fraction
phosphatidylinositol 3 kinase/protein kinase B
Roux-en-y gastric bypass
sex hormone binding globulin
tumor necrosis factor-α
vascular endothelial growth factor
World Cancer Research Fund
World Cancer Research Fund/American Institute for Cancer Research
World Health Organization
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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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