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Insulin Resistance and Cancer pp 269–291Cite as

Insulin Resistance: Clinical Implications for Cancer Treatment and Prevention

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Part of the book series: Energy Balance and Cancer ((EBAC,volume 1))

Abstract

Obesity is a major threat to health worldwide and if the current trend continues, more than 50% of the world’s population is projected to be obese by the year 2030 [1]. As reviewed by Irwin et al. in another chapter [2], obesity has been linked to both cancer risk and cancer outcome. Although obesity, insulin resistance and hyperinsulinemia are interrelated [3], until recently the primary focus of epidemiologic and clinical cancer research has been on obesity. Eugenia Calle et al. [4] provided an elegant demonstration of the association between body size and mortality from cancer in the prospective Cancer Prevention Study II, conducted by the American Cancer Society. Studying over 900,000 American adults, they found that individuals with a body mass index (BMI  =  weight(kg)/height(m)2) of at least 40 had death rates from cancer that were 52% higher (for men) and 62% higher (for women) than the rates seen in normal weight individuals. Higher BMI was significantly associated with increased death rates from a number of common cancers, including colon and rectum, breast, uterus and prostate as well as from less common cancers such as liver, gallbladder, pancreas, kidney, stomach, cervix, non-Hodgkin’s lymphoma and multiple myeloma. The only cancer demonstrating an inverse association between BMI and future cancer mortality was lung cancer. The results of this study (which combine the effect of obesity on cancer risk and cancer progression) suggest that obesity may contribute to 14% of all deaths from cancer in men and 20% of all deaths from cancer in women, evidence of an important contribution of obesity to cancer death. Similar results were obtained in a recent study by Whitlock et al. [5] in an analysis involving approximately 90,000 subjects that ­obesity was associated with significantly increased mortality from several causes, including cancer; with every 5 kg/m2 increase in BMI, risk of cancer-specific ­mortality increased by 10%. Furthermore, a recent meta-analysis by Renehan et al. [6] that focused on cancer incidence rather than mortality, reported that increased BMI was associated with increased risk of several different cancers including esophageal, thyroid, colon, rectal, renal, endometrial, gallbladder, breast (postmenopausal) and pancreatic, as well as melanoma, leukaemia, multiple myeloma, and non-Hodgkin lymphoma.

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  1. Samuel Lunenfeld Research Institute, Mount Sinai Hospital and Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada

    Saroj Niraula & Pamela J. Goodwin

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  1. Saroj Niraula
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  2. Pamela J. Goodwin
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  1. Mount Sinai Hospital, Dept. Medicine, University of Toronto, Murray St. 60, Toronto, M5T 3L9, Ontario, Canada

    I. George Fantus

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Niraula, S., Goodwin, P.J. (2011). Insulin Resistance: Clinical Implications for Cancer Treatment and Prevention. In: Fantus, I. (eds) Insulin Resistance and Cancer. Energy Balance and Cancer, vol 1. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9911-5_12

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