Obesity and Cancer

  • Samer A. NaffoujeEmail author
  • George I. Salti


Obesity is a rapidly expanding epidemic worldwide, particularly in Western countries. As the prevalence of obesity is increasing, a heavy burden is being rested on societies and healthcare systems manifested by a phenomenal growing rate of obesity-related morbidities and mortalities.

In the past few decades, an increasing body of evidence has been accumulating to confirm the strong ties between obesity and the increasing occurrence of certain malignancies on one end or the emergence of aggressive phenotypes on the other.

In this chapter, we aim to explore the molecular dysregulations that arise as the obese body builds up excessive amounts of adipose tissue and summarize the biologic processes that connect two common, challenging, and influential diseases in our contemporary surgical practice, obesity and cancer.


Cancer Obesity Tumorigenesis Mechanism Risk factor 


  1. 1.
    Caballero B. The global epidemic of obesity: an overview. Epidemiol Rev. 2007;29:1–5.PubMedCrossRefGoogle Scholar
  2. 2.
    Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA. 2002;288(14):1723–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Howard NJ, Taylor AW, Gill TK, Chittleborough CR. Severe obesity: investigating the socio-demographics within the extremes of body mass index. Obes Res Clin Pract. 2008;2(1):I–II.PubMedCrossRefGoogle Scholar
  4. 4.
    Sturm R. Increases in morbid obesity in the USA: 2000–2005. Public Health. 2007;121(7):492–6.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238–45.PubMedCrossRefGoogle Scholar
  6. 6.
    Flegal KM, Williamson DF, Pamuk ER, Rosenberg HM. Estimating deaths attributable to obesity in the United States. Am J Public Health. 2004;94(9):1486–9.PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    Adams KF, Schatzkin A, Harris TB, Kipnis V, Mouw T, Ballard-Barbash R, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006;355(8):763–78.PubMedCrossRefGoogle Scholar
  8. 8.
    Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ, et al. Body-mass index and mortality among 146 million white adults. N Engl J Med. 2010;363(23):2211–9.PubMedCrossRefGoogle Scholar
  9. 9.
    de Koning L, Merchant AT, Pogue J, Anand SS. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur Heart J. 2007;28(7):850–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083–96.PubMedCrossRefGoogle Scholar
  11. 11.
    Polednak AP. Estimating the number of U.S. incident cancers attributable to obesity and the impact on temporal trends in incidence rates for obesity-related cancers. Cancer Detect Prev. 2008;32(3):190–9.PubMedCrossRefGoogle Scholar
  12. 12.
    National Institute of Health NCI. Obesity and cancer risk. National Cancer Institute; 2012. Available from:
  13. 13.
    Society AC. Cancer facts & figures 2012. 2012. Available from:
  14. 14.
    Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Aff (Millwood). 2009;28(5):w822–31.CrossRefGoogle Scholar
  15. 15.
    Finkelstein EA, Khavjou OA, Thompson H, Trogdon JG, Pan L, Sherry B, et al. Obesity and severe obesity forecasts through 2030. Am J Prev Med. 2012;42(6):563–70.PubMedCrossRefGoogle Scholar
  16. 16.
    Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011;378(9793):815–25.PubMedCrossRefGoogle Scholar
  17. 17.
    Vainio H, Bianchini F, editors. Weight control and physical activity. Lyon: IARC Press/International Agency for Research in Cancer; 2002.Google Scholar
  18. 18.
    Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington, DC: World Cancer Research Fund; 2007.Google Scholar
  19. 19.
    Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569–78.PubMedCrossRefGoogle Scholar
  20. 20.
    McKeown-Eyssen G. Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk? Cancer Epidemiol Biomark Prev. 1994;3(8):687–95.Google Scholar
  21. 21.
    Giovannucci E. Insulin and colon cancer. Cancer Causes Control. 1995;6(2):164–79.PubMedCrossRefGoogle Scholar
  22. 22.
    Roberts DL, Dive C, Renehan AG. Biological mechanisms linking obesity and cancer risk: new perspectives. Annu Rev Med. 2010;61:301–16.PubMedCrossRefGoogle Scholar
  23. 23.
    Renehan AG, Zwahlen M, Minder C, O’Dwyer ST, Shalet SM, Egger M. Insulin-like growth factor (IGF)-I, IGF binding protein-3, and cancer risk: systematic review and meta-regression analysis. Lancet. 2004;363(9418):1346–53.PubMedCrossRefGoogle Scholar
  24. 24.
    Renehan AG, Harvie M, Howell A. Insulin-like growth factor (IGF)-I, IGF binding protein-3, and breast cancer risk: eight years on. Endocr Relat Cancer. 2006;13(2):273–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Chan BT, Lee AV. Insulin receptor substrates (IRSs) and breast tumorigenesis. J Mammary Gland Biol Neoplasia. 2008;13(4):415–22.PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Renehan AG. Hormones, growth factors, and tumor growth. Oxford: Oxford University Press; 2007.Google Scholar
  27. 27.
    Key TJ, Appleby PN, Reeves GK, Roddam A, Dorgan JF, Longcope C, et al. Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. J Natl Cancer Inst. 2003;95(16):1218–26.PubMedCrossRefGoogle Scholar
  28. 28.
    Kaaks R, Rinaldi S, Key TJ, Berrino F, Peeters PH, Biessy C, et al. Postmenopausal serum androgens, oestrogens and breast cancer risk: the European prospective investigation into cancer and nutrition. Endocr Relat Cancer. 2005;12(4):1071–82.PubMedCrossRefGoogle Scholar
  29. 29.
    Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4(8):579–91.CrossRefPubMedGoogle Scholar
  30. 30.
    Kaaks R, Lukanova A, Kurzer MS. Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomark Prev. 2002;11(12):1531–43.Google Scholar
  31. 31.
    Fischer-Posovszky P, Wabitsch M, Hochberg Z. Endocrinology of adipose tissue – an update. Horm Metab Res. 2007;39(5):314–21.PubMedCrossRefGoogle Scholar
  32. 32.
    Friedman JM, Leibel RL, Bahary N. Molecular mapping of obesity genes. Mamm Genome. 1991;1(3):130–44.PubMedCrossRefGoogle Scholar
  33. 33.
    Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM. Positional cloning of the mouse obese gene and its human homologue. Nature. 1994;372(6505):425–32.PubMedCrossRefGoogle Scholar
  34. 34.
    Schaffler A, Scholmerich J, Buechler C. Mechanisms of disease: adipokines and breast cancer – endocrine and paracrine mechanisms that connect adiposity and breast cancer. Nat Clin Pract Endocrinol Metab. 2007;3(4):345–54.PubMedCrossRefGoogle Scholar
  35. 35.
    Vona-Davis L, Rose DP. Adipokines as endocrine, paracrine, and autocrine factors in breast cancer risk and progression. Endocr Relat Cancer. 2007;14(2):189–206.PubMedCrossRefGoogle Scholar
  36. 36.
    Bray GA. The underlying basis for obesity: relationship to cancer. J Nutr. 2002;132(11 Suppl):3451S–5S.PubMedCrossRefGoogle Scholar
  37. 37.
    Rose DP, Komninou D, Stephenson GD. Obesity, adipocytokines, and insulin resistance in breast cancer. Obes Rev. 2004;5(3):153–65.PubMedCrossRefGoogle Scholar
  38. 38.
    Fasshauer M, Klein J, Neumann S, Eszlinger M, Paschke R. Hormonal regulation of adiponectin gene expression in 3T3-L1 adipocytes. Biochem Biophys Res Commun. 2002;290(3):1084–9.PubMedCrossRefGoogle Scholar
  39. 39.
    Dieudonne MN, Bussiere M, Dos Santos E, Leneveu MC, Giudicelli Y, Pecquery R. Adiponectin mediates antiproliferative and apoptotic responses in human MCF7 breast cancer cells. Biochem Biophys Res Commun. 2006;345(1):271–9.PubMedCrossRefGoogle Scholar
  40. 40.
    Brakenhielm E, Veitonmaki N, Cao R, Kihara S, Matsuzawa Y, Zhivotovsky B, et al. Adiponectin-induced antiangiogenesis and antitumor activity involve caspase-mediated endothelial cell apoptosis. Proc Natl Acad Sci U S A. 2004;101(8):2476–81.PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Petridou E, Mantzoros C, Dessypris N, Koukoulomatis P, Addy C, Voulgaris Z, et al. Plasma adiponectin concentrations in relation to endometrial cancer: a case-control study in Greece. J Clin Endocrinol Metab. 2003;88(3):993–7.PubMedCrossRefGoogle Scholar
  42. 42.
    Dal Maso L, Augustin LS, Karalis A, Talamini R, Franceschi S, Trichopoulos D, et al. Circulating adiponectin and endometrial cancer risk. J Clin Endocrinol Metab. 2004;89(3):1160–3.PubMedCrossRefGoogle Scholar
  43. 43.
    Miyoshi Y, Funahashi T, Kihara S, Taguchi T, Tamaki Y, Matsuzawa Y, et al. Association of serum adiponectin levels with breast cancer risk. Clin Cancer Res. 2003;9(15):5699–704.PubMedGoogle Scholar
  44. 44.
    Mantzoros C, Petridou E, Dessypris N, Chavelas C, Dalamaga M, Alexe DM, et al. Adiponectin and breast cancer risk. J Clin Endocrinol Metab. 2004;89(3):1102–7.PubMedCrossRefGoogle Scholar
  45. 45.
    Wei EK, Giovannucci E, Fuchs CS, Willett WC, Mantzoros CS. Low plasma adiponectin levels and risk of colorectal cancer in men: a prospective study. J Natl Cancer Inst. 2005;97(22):1688–94.PubMedCrossRefGoogle Scholar
  46. 46.
    Goktas S, Yilmaz MI, Caglar K, Sonmez A, Kilic S, Bedir S. Prostate cancer and adiponectin. Urology. 2005;65(6):1168–72.PubMedCrossRefGoogle Scholar
  47. 47.
    Zhang Y, Daquinag A, Traktuev DO, Amaya-Manzanares F, Simmons PJ, March KL, et al. White adipose tissue cells are recruited by experimental tumors and promote cancer progression in mouse models. Cancer Res. 2009;69(12):5259–66.PubMedCrossRefGoogle Scholar
  48. 48.
    Bedogni B, Welford SM, Cassarino DS, Nickoloff BJ, Giaccia AJ, Powell MB. The hypoxic microenvironment of the skin contributes to Akt-mediated melanocyte transformation. Cancer Cell. 2005;8(6):443–54.PubMedCrossRefGoogle Scholar
  49. 49.
    Bedogni B, Welford SM, Kwan AC, Ranger-Moore J, Saboda K, Powell MB. Inhibition of phosphatidylinositol-3-kinase and mitogen-activated protein kinase kinase 1/2 prevents melanoma development and promotes melanoma regression in the transgenic TPRas mouse model. Mol Cancer Ther. 2006;5(12):3071–7.PubMedCrossRefGoogle Scholar
  50. 50.
    World Cancer Report 2014. World Health Organization; 2014.Google Scholar
  51. 51.
    Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.PubMedCrossRefGoogle Scholar
  52. 52.
    Mayer RJ. Harrison’s principles of internal medicine. 18th ed. New York: McGraw-Hill Medical Publishing Division; 2008.Google Scholar
  53. 53.
    American Cancer Society. Cancer facts & figures 2016. Available at Accessed 8 Aug.
  54. 54.
    Pohl H, Welch HG. The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst. 2005;97(2):142–6.PubMedCrossRefGoogle Scholar
  55. 55.
    Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62(1):10–29.PubMedCrossRefGoogle Scholar
  56. 56.
    Raman R, Deorah S, McDowell BD, Abu Hejleh T, Lynch CF, Gupta A. Changing incidence of esophageal cancer among white women: analysis of SEER data (1992–2010). Contemp Oncol (Pozn). 2015;19(4):338–40.PubMedCentralPubMedGoogle Scholar
  57. 57.
    Brown LM, Swanson CA, Gridley G, Swanson GM, Schoenberg JB, Greenberg RS, et al. Adenocarcinoma of the esophagus: role of obesity and diet. J Natl Cancer Inst. 1995;87(2):104–9.PubMedCrossRefGoogle Scholar
  58. 58.
    Vaughan TL, Davis S, Kristal A, Thomas DB. Obesity, alcohol, and tobacco as risk factors for cancers of the esophagus and gastric cardia: adenocarcinoma versus squamous cell carcinoma. Cancer Epidemiol Biomark Prev. 1995;4(2):85–92.Google Scholar
  59. 59.
    Whiteman DC, Sadeghi S, Pandeya N, Smithers BM, Gotley DC, Bain CJ, et al. Combined effects of obesity, acid reflux and smoking on the risk of adenocarcinomas of the oesophagus. Gut. 2008;57(2):173–80.PubMedCrossRefGoogle Scholar
  60. 60.
    Chow WH, Blot WJ, Vaughan TL, Risch HA, Gammon MD, Stanford JL, et al. Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst. 1998;90(2):150–5.PubMedCrossRefGoogle Scholar
  61. 61.
    Abnet CC, Freedman ND, Hollenbeck AR, Fraumeni JF Jr, Leitzmann M, Schatzkin A. A prospective study of BMI and risk of oesophageal and gastric adenocarcinoma. Eur J Cancer. 2008;44(3):465–71.PubMedPubMedCentralCrossRefGoogle Scholar
  62. 62.
    Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D, et al. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ. 2007;335(7630):1134.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Samanic C, Chow WH, Gridley G, Jarvholm B, Fraumeni JF Jr. Relation of body mass index to cancer risk in 362,552 Swedish men. Cancer Causes Control. 2006;17(7):901–9.PubMedCrossRefGoogle Scholar
  64. 64.
    Merry AH, Schouten LJ, Goldbohm RA, van den Brandt PA. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: a prospective cohort study. Gut. 2007;56(11):1503–11.PubMedPubMedCentralCrossRefGoogle Scholar
  65. 65.
    MacInnis RJ, English DR, Hopper JL, Giles GG. Body size and composition and the risk of gastric and oesophageal adenocarcinoma. Int J Cancer. 2006;118(10):2628–31.PubMedCrossRefGoogle Scholar
  66. 66.
    Engeland A, Tretli S, Bjorge T. Height and body mass index in relation to esophageal cancer; 23-year follow-up of two million Norwegian men and women. Cancer Causes Control. 2004;15(8):837–43.PubMedCrossRefGoogle Scholar
  67. 67.
    Lagergren J, Bergstrom R, Nyren O. Association between body mass and adenocarcinoma of the esophagus and gastric cardia. Ann Intern Med. 1999;130(11):883–90.PubMedCrossRefGoogle Scholar
  68. 68.
    Veugelers PJ, Porter GA, Guernsey DL, Casson AG. Obesity and lifestyle risk factors for gastroesophageal reflux disease, Barrett esophagus and esophageal adenocarcinoma. Dis Esophagus. 2006;19(5):321–8.PubMedCrossRefGoogle Scholar
  69. 69.
    Figueroa JD, Terry MB, Gammon MD, Vaughan TL, Risch HA, Zhang FF, et al. Cigarette smoking, body mass index, gastro-esophageal reflux disease, and non-steroidal anti-inflammatory drug use and risk of subtypes of esophageal and gastric cancers by P53 overexpression. Cancer Causes Control. 2009;20(3):361–8.PubMedCrossRefGoogle Scholar
  70. 70.
    Ryan AM, Rowley SP, Fitzgerald AP, Ravi N, Reynolds JV. Adenocarcinoma of the oesophagus and gastric cardia: male preponderance in association with obesity. Eur J Cancer. 2006;42(8):1151–8.PubMedCrossRefGoogle Scholar
  71. 71.
    Corley DA, Kubo A, Zhao W. Abdominal obesity and the risk of esophageal and gastric cardia carcinomas. Cancer Epidemiol Biomark Prev. 2008;17(2):352–8.CrossRefGoogle Scholar
  72. 72.
    Chen Q, Zhuang H, Liu Y. The association between obesity factor and esophageal cancer. J Gastrointest Oncol. 2012;3(3):226–31.PubMedPubMedCentralGoogle Scholar
  73. 73.
    McElholm AR, McKnight AJ, Patterson CC, Johnston BT, Hardie LJ, Murray LJ, et al. A population-based study of IGF axis polymorphisms and the esophageal inflammation, metaplasia, adenocarcinoma sequence. Gastroenterology. 2010;139(1):204–12 e3.PubMedCrossRefGoogle Scholar
  74. 74.
    MacDonald K, Porter GA, Guernsey DL, Zhao R, Casson AG. A polymorphic variant of the insulin-like growth factor type I receptor gene modifies risk of obesity for esophageal adenocarcinoma. Cancer Epidemiol. 2009;33(1):37–40.PubMedCrossRefGoogle Scholar
  75. 75.
    Armstrong RW, Borman B. Trends in incidence rates of adenocarcinoma of the oesophagus and gastric cardia in New Zealand, 1978–1992. Int J Epidemiol. 1996;25(5):941–7.PubMedCrossRefGoogle Scholar
  76. 76.
    Lepage C, Rachet B, Jooste V, Faivre J, Coleman MP. Continuing rapid increase in esophageal adenocarcinoma in England and Wales. Am J Gastroenterol. 2008;103(11):2694–9.PubMedCrossRefGoogle Scholar
  77. 77.
    Brown LM, Devesa SS, Chow WH. Incidence of adenocarcinoma of the esophagus among white Americans by sex, stage, and age. J Natl Cancer Inst. 2008;100(16):1184–7.PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    World Cancer Report. International Agency for Research on Cancer; 2008.Google Scholar
  79. 79.
    Breast cancer: prevention and control. World Health Organization.Google Scholar
  80. 80.
    Rose DP, Vona-Davis L. Biochemical and molecular mechanisms for the association between obesity, chronic inflammation, and breast cancer. Biofactors. 2014;40(1):1–12.PubMedCrossRefGoogle Scholar
  81. 81.
    Millikan RC, Newman B, Tse CK, Moorman PG, Conway K, Dressler LG, et al. Epidemiology of basal-like breast cancer. Breast Cancer Res Treat. 2008;109(1):123–39.PubMedCrossRefGoogle Scholar
  82. 82.
    Vona-Davis L, Rose DP, Hazard H, Howard-McNatt M, Adkins F, Partin J, et al. Triple-negative breast cancer and obesity in a rural Appalachian population. Cancer Epidemiol Biomark Prev. 2008;17(12):3319–24.CrossRefGoogle Scholar
  83. 83.
    Trivers KF, Lund MJ, Porter PL, Liff JM, Flagg EW, Coates RJ, et al. The epidemiology of triple-negative breast cancer, including race. Cancer Causes Control. 2009;20(7):1071–82.PubMedPubMedCentralCrossRefGoogle Scholar
  84. 84.
    Yang XR, Chang-Claude J, Goode EL, Couch FJ, Nevanlinna H, Milne RL, et al. Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the Breast Cancer Association Consortium studies. J Natl Cancer Inst. 2011;103(3):250–63.PubMedCrossRefGoogle Scholar
  85. 85.
    Pierobon M, Frankenfeld CL. Obesity as a risk factor for triple-negative breast cancers: a systematic review and meta-analysis. Breast Cancer Res Treat. 2013;137(1):307–14.PubMedCrossRefGoogle Scholar
  86. 86.
    Rose DP, Gracheck PJ, Vona-Davis L. The interactions of obesity, inflammation and insulin resistance in breast cancer. Cancers (Basel). 2015;7(4):2147–68.CrossRefGoogle Scholar
  87. 87.
    Sestak I, Distler W, Forbes JF, Dowsett M, Howell A, Cuzick J. Effect of body mass index on recurrences in tamoxifen and anastrozole treated women: an exploratory analysis from the ATAC trial. J Clin Oncol. 2010;28(21):3411–5.PubMedCrossRefGoogle Scholar
  88. 88.
    Pfeiler G, Stoger H, Dubsky P, Mlineritsch B, Singer C, Balic M, et al. Efficacy of tamoxifen +/− aminoglutethimide in normal weight and overweight postmenopausal patients with hormone receptor-positive breast cancer: an analysis of 1509 patients of the ABCSG-06 trial. Br J Cancer. 2013;108(7):1408–14.PubMedPubMedCentralCrossRefGoogle Scholar
  89. 89.
    Kabat GC, Kim M, Caan BJ, Chlebowski RT, Gunter MJ, Ho GY, et al. Repeated measures of serum glucose and insulin in relation to postmenopausal breast cancer. Int J Cancer. 2009;125(11):2704–10.PubMedCrossRefGoogle Scholar
  90. 90.
    Gunter MJ, Hoover DR, Yu H, Wassertheil-Smoller S, Rohan TE, Manson JE, et al. Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Inst. 2009;101(1):48–60.PubMedPubMedCentralCrossRefGoogle Scholar
  91. 91.
    Kim S, Choi JH, Kim JB, Nam SJ, Yang JH, Kim JH, et al. Berberine suppresses TNF-alpha-induced MMP-9 and cell invasion through inhibition of AP-1 activity in MDA-MB-231 human breast cancer cells. Molecules. 2008;13(12):2975–85.PubMedCrossRefGoogle Scholar
  92. 92.
    Eichbaum C, Meyer AS, Wang N, Bischofs E, Steinborn A, Bruckner T, et al. Breast cancer cell-derived cytokines, macrophages and cell adhesion: implications for metastasis. Anticancer Res. 2011;31(10):3219–27.PubMedGoogle Scholar
  93. 93.
    Murdoch C, Muthana M, Coffelt SB, Lewis CE. The role of myeloid cells in the promotion of tumour angiogenesis. Nat Rev Cancer. 2008;8(8):618–31.PubMedCrossRefGoogle Scholar
  94. 94.
    Keeley EC, Mehrad B, Strieter RM. Chemokines as mediators of tumor angiogenesis and neovascularization. Exp Cell Res. 2011;317(5):685–90.PubMedCrossRefGoogle Scholar
  95. 95.
    Engeli S, Feldpausch M, Gorzelniak K, Hartwig F, Heintze U, Janke J, et al. Association between adiponectin and mediators of inflammation in obese women. Diabetes. 2003;52(4):942–7.PubMedCrossRefGoogle Scholar
  96. 96.
    Huang Z, Willett WC, Colditz GA, Hunter DJ, Manson JE, Rosner B, et al. Waist circumference, waist: hip ratio, and risk of breast cancer in the Nurses’ Health Study. Am J Epidemiol. 1999;150(12):1316–24.PubMedCrossRefGoogle Scholar
  97. 97.
    Connolly BS, Barnett C, Vogt KN, Li T, Stone J, Boyd NF. A meta-analysis of published literature on waist-to-hip ratio and risk of breast cancer. Nutr Cancer. 2002;44(2):127–38.PubMedCrossRefGoogle Scholar
  98. 98.
    National Cancer Institute. DevCan: probability of developing or dying of cancer software statistical research and applications branch. National Cancer Institute.Google Scholar
  99. 99.
    Edwards BK, Ward E, Kohler BA, Eheman C, Zauber AG, Anderson RN, et al. Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer. 2010;116(3):544–73.PubMedPubMedCentralCrossRefGoogle Scholar
  100. 100.
    Bardou M, Barkun AN, Martel M. Obesity and colorectal cancer. Gut. 2013;62(6):933–47.PubMedCrossRefGoogle Scholar
  101. 101.
    Ben Q, An W, Jiang Y, Zhan X, Du Y, Cai QC, et al. Body mass index increases risk for colorectal adenomas based on meta-analysis. Gastroenterology. 2012;142(4):762–72.PubMedCrossRefGoogle Scholar
  102. 102.
    Hong S, Cai Q, Chen D, Zhu W, Huang W, Li Z. Abdominal obesity and the risk of colorectal adenoma: a meta-analysis of observational studies. Eur J Cancer Prev. 2012;21(6):523–31.PubMedCrossRefGoogle Scholar
  103. 103.
    Lee YJ, Myung SK, Cho B, Park BJ, Park JH, Ju W, et al. Adiposity and the risk of colorectal adenomatous polyps: a meta-analysis. Cancer Causes Control. 2011;22(7):1021–35.PubMedCrossRefGoogle Scholar
  104. 104.
    Okabayashi K, Ashrafian H, Hasegawa H, Yoo JH, Patel VM, Harling L, et al. Body mass index category as a risk factor for colorectal adenomas: a systematic review and meta-analysis. Am J Gastroenterol. 2012;107(8):1175–85; quiz 86PubMedCrossRefGoogle Scholar
  105. 105.
    Kim BC, Shin A, Hong CW, Sohn DK, Han KS, Ryu KH, et al. Association of colorectal adenoma with components of metabolic syndrome. Cancer Causes Control. 2012;23(5):727–35.PubMedCrossRefGoogle Scholar
  106. 106.
    Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88.PubMedPubMedCentralCrossRefGoogle Scholar
  107. 107.
    Harriss DJ, Atkinson G, George K, Cable NT, Reilly T, Haboubi N, et al. Lifestyle factors and colorectal cancer risk (1): systematic review and meta-analysis of associations with body mass index. Color Dis. 2009;11(6):547–63.CrossRefGoogle Scholar
  108. 108.
    Dai Z, Xu YC, Niu L. Obesity and colorectal cancer risk: a meta-analysis of cohort studies. World J Gastroenterol. 2007;13(31):4199–206.PubMedPubMedCentralCrossRefGoogle Scholar
  109. 109.
    Moghaddam AA, Woodward M, Huxley R. Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events. Cancer Epidemiol Biomark Prev. 2007;16(12):2533–47.CrossRefGoogle Scholar
  110. 110.
    Larsson SC, Wolk A. Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr. 2007;86(3):556–65.PubMedCrossRefGoogle Scholar
  111. 111.
    Akiyoshi T, Ueno M, Fukunaga Y, Nagayama S, Fujimoto Y, Konishi T, et al. Effect of body mass index on short-term outcomes of patients undergoing laparoscopic resection for colorectal cancer: a single institution experience in Japan. Surg Laparosc Endosc Percutan Tech. 2011;21(6):409–14.PubMedCrossRefGoogle Scholar
  112. 112.
    Ballian N, Yamane B, Leverson G, Harms B, Heise CP, Foley EF, et al. Body mass index does not affect postoperative morbidity and oncologic outcomes of total mesorectal excision for rectal adenocarcinoma. Ann Surg Oncol. 2010;17(6):1606–13.PubMedCrossRefGoogle Scholar
  113. 113.
    Bege T, Lelong B, Francon D, Turrini O, Guiramand J, Delpero JR. Impact of obesity on short-term results of laparoscopic rectal cancer resection. Surg Endosc. 2009;23(7):1460–4.PubMedCrossRefGoogle Scholar
  114. 114.
    Blee TH, Belzer GE, Lambert PJ. Obesity: is there an increase in perioperative complications in those undergoing elective colon and rectal resection for carcinoma? Am Surg. 2002;68(2):163–6.PubMedGoogle Scholar
  115. 115.
    Blumberg D. Laparoscopic colectomy performed using a completely intracorporeal technique is associated with similar outcome in obese and thin patients. Surg Laparosc Endosc Percutan Tech. 2009;19(1):57–61.PubMedCrossRefGoogle Scholar
  116. 116.
    Chern H, Chou J, Donkor C, Shia J, Guillem JG, Nash GM, et al. Effects of obesity in rectal cancer surgery. J Am Coll Surg. 2010;211(1):55–60.PubMedCrossRefGoogle Scholar
  117. 117.
    Damadi AA, Julien L, Arrangoiz R, Raiji M, Weise D, Saxe AW. Does obesity influence lymph node harvest among patients undergoing colectomy for colon cancer? Am Surg. 2008;74(11):1073–7.PubMedGoogle Scholar
  118. 118.
    Healy LA, Ryan AM, Sutton E, Younger K, Mehigan B, Stephens R, et al. Impact of obesity on surgical and oncological outcomes in the management of colorectal cancer. Int J Color Dis. 2010;25(11):1293–9.CrossRefGoogle Scholar
  119. 119.
    Ishii Y, Hasegawa H, Nishibori H, Watanabe M, Kitajima M. Impact of visceral obesity on surgical outcome after laparoscopic surgery for rectal cancer. Br J Surg. 2005;92(10):1261–2.PubMedCrossRefGoogle Scholar
  120. 120.
    Kang J, Baek SE, Kim T, Hur H, Min BS, Lim JS, et al. Impact of fat obesity on laparoscopic total mesorectal excision: more reliable indicator than body mass index. Int J Color Dis. 2012;27(4):497–505.CrossRefGoogle Scholar
  121. 121.
    Karahasanoglu T, Hamzaoglu I, Baca B, Aytac E, Kirbiyik E. Impact of increased body mass index on laparoscopic surgery for rectal cancer. Eur Surg Res. 2011;46(2):87–93.PubMedCrossRefGoogle Scholar
  122. 122.
    Linebarger JH, Mathiason MA, Kallies KJ, Shapiro SB. Does obesity impact lymph node retrieval in colon cancer surgery? Am J Surg. 2010;200(4):478–82.PubMedCrossRefGoogle Scholar
  123. 123.
    Merkow RP, Bilimoria KY, McCarter MD, Bentrem DJ. Effect of body mass index on short-term outcomes after colectomy for cancer. J Am Coll Surg. 2009;208(1):53–61.PubMedCrossRefGoogle Scholar
  124. 124.
    Nitori N, Hasegawa H, Ishii Y, Endo T, Kitagawa Y. Impact of visceral obesity on short-term outcome after laparoscopic surgery for colorectal cancer: a single Japanese center study. Surg Laparosc Endosc Percutan Tech. 2009;19(4):324–7.PubMedCrossRefGoogle Scholar
  125. 125.
    Park JS, Choi GS, Jang YS, Jun SH, Kang H. Influence of obesity on the serum carcinoembryonic antigen value in patients with colorectal cancer. Cancer Epidemiol Biomark Prev. 2010;19(10):2461–8.CrossRefGoogle Scholar
  126. 126.
    Poulsen M, Ovesen H. Is laparoscopic colorectal cancer surgery in obese patients associated with an increased risk? Short-term results from a single center study of 425 patients. J Gastrointest Surg. 2012;16(8):1554–8.PubMedCrossRefGoogle Scholar
  127. 127.
    Sakamoto K, Niwa S, Tanaka M, Goto M, Sengoku H, Tomiki Y. Influence of obesity on the short-term outcome of laparoscopic colectomy for colorectal cancer. J Minim Access Surg. 2007;3(3):98–103.PubMedPubMedCentralCrossRefGoogle Scholar
  128. 128.
    Singh A, Muthukumarasamy G, Pawa N, Riaz AA, Hendricks JB, Motson RW. Laparoscopic colorectal cancer surgery in obese patients. Color Dis. 2011;13(8):878–83.CrossRefGoogle Scholar
  129. 129.
    Tsujinaka S, Konishi F, Kawamura YJ, Saito M, Tajima N, Tanaka O, et al. Visceral obesity predicts surgical outcomes after laparoscopic colectomy for sigmoid colon cancer. Dis Colon Rectum. 2008;51(12):1757–65; discussion 65–7.PubMedCrossRefGoogle Scholar
  130. 130.
    Yamamoto N, Fujii S, Sato T, Oshima T, Rino Y, Kunisaki C, et al. Impact of body mass index and visceral adiposity on outcomes in colorectal cancer. Asia Pac J Clin Oncol. 2012;8(4):337–45.PubMedCrossRefGoogle Scholar
  131. 131.
    Makino T, Shukla PJ, Rubino F, Milsom JW. The impact of obesity on perioperative outcomes after laparoscopic colorectal resection. Ann Surg. 2012;255(2):228–36.PubMedCrossRefGoogle Scholar
  132. 132.
    Zhou Y, Wu L, Li X, Wu X, Li B. Outcome of laparoscopic colorectal surgery in obese and nonobese patients: a meta-analysis. Surg Endosc. 2012;26(3):783–9.PubMedCrossRefGoogle Scholar
  133. 133.
    Park JW, Lim SW, Choi HS, Jeong SY, Oh JH, Lim SB. The impact of obesity on outcomes of laparoscopic surgery for colorectal cancer in Asians. Surg Endosc. 2010;24(7):1679–85.PubMedCrossRefGoogle Scholar
  134. 134.
    Coleman MP, Gatta G, Verdecchia A, Esteve J, Sant M, Storm H, et al. EUROCARE-3 summary: cancer survival in Europe at the end of the 20th century. Ann Oncol. 2003;14(Suppl 5):v128–49.PubMedCrossRefGoogle Scholar
  135. 135.
    Horner MJRL, Krapcho M, Neyman N, Aminou R, Howlader N, Altekruse SF, Feuer EJ, Huang L, Mariotto A, Miller BA, Lewis DR, Eisner MP, Stinchcomb DG, Edwards BK. SEER cancer statistics review, 1975–2006. Bethesda: National Cancer Institute; 2008.Google Scholar
  136. 136.
    El-Serag HB, Mason AC. Risk factors for the rising rates of primary liver cancer in the United States. Arch Intern Med. 2000;160(21):3227–30.PubMedCrossRefGoogle Scholar
  137. 137.
    Hassan MM, Frome A, Patt YZ, El-Serag HB. Rising prevalence of hepatitis C virus infection among patients recently diagnosed with hepatocellular carcinoma in the United States. J Clin Gastroenterol. 2002;35(3):266–9.PubMedCrossRefGoogle Scholar
  138. 138.
    Moller H, Mellemgaard A, Lindvig K, Olsen JH. Obesity and cancer risk: a Danish record-linkage study. Eur J Cancer. 1994;30A(3):344–50.PubMedCrossRefGoogle Scholar
  139. 139.
    Wolk A, Gridley G, Svensson M, Nyren O, McLaughlin JK, Fraumeni JF, et al. A prospective study of obesity and cancer risk (Sweden). Cancer Causes Control. 2001;12(1):13–21.PubMedCrossRefGoogle Scholar
  140. 140.
    Nair S, Mason A, Eason J, Loss G, Perrillo RP. Is obesity an independent risk factor for hepatocellular carcinoma in cirrhosis? Hepatology. 2002;36(1):150–5.PubMedCrossRefPubMedCentralGoogle Scholar
  141. 141.
    Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med. 2003;348(17):1625–38.CrossRefPubMedGoogle Scholar
  142. 142.
    Samanic C, Gridley G, Chow WH, Lubin J, Hoover RN, Fraumeni JF Jr. Obesity and cancer risk among white and black United States veterans. Cancer Causes Control. 2004;15(1):35–43.PubMedCrossRefGoogle Scholar
  143. 143.
    Batty GD, Shipley MJ, Jarrett RJ, Breeze E, Marmot MG, Smith GD. Obesity and overweight in relation to organ-specific cancer mortality in London (UK): findings from the original Whitehall study. Int J Obes. 2005;29(10):1267–74.CrossRefGoogle Scholar
  144. 144.
    Oh SW, Yoon YS, Shin SA. Effects of excess weight on cancer incidences depending on cancer sites and histologic findings among men: Korea National Health Insurance Corporation Study. J Clin Oncol. 2005;23(21):4742–54.PubMedCrossRefPubMedCentralGoogle Scholar
  145. 145.
    Rapp K, Schroeder J, Klenk J, Stoehr S, Ulmer H, Concin H, et al. Obesity and incidence of cancer: a large cohort study of over 145,000 adults in Austria. Br J Cancer. 2005;93(9):1062–7.PubMedPubMedCentralCrossRefGoogle Scholar
  146. 146.
    N’Kontchou G, Paries J, Htar MT, Ganne-Carrie N, Costentin L, Grando-Lemaire V, et al. Risk factors for hepatocellular carcinoma in patients with alcoholic or viral C cirrhosis. Clin Gastroenterol Hepatol. 2006;4(8):1062–8.PubMedCrossRefGoogle Scholar
  147. 147.
    Larsson SC, Wolk A. Overweight, obesity and risk of liver cancer: a meta-analysis of cohort studies. Br J Cancer. 2007;97(7):1005–8.PubMedPubMedCentralCrossRefGoogle Scholar
  148. 148.
    Neuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology. 2003;37(5):1202–19.PubMedCrossRefGoogle Scholar
  149. 149.
    Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90.PubMedCrossRefPubMedCentralGoogle Scholar
  150. 150.
    Levy AD, Murakata LA, Rohrmann CA Jr. Gallbladder carcinoma: radiologic-pathologic correlation. Radiographics. 2001;21(2):295–314; questionnaire, 549–55.PubMedCrossRefGoogle Scholar
  151. 151.
    Lazcano-Ponce EC, Miquel JF, Munoz N, Herrero R, Ferrecio C, Wistuba II, et al. Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin. 2001;51(6):349–64.PubMedCrossRefGoogle Scholar
  152. 152.
    Zatonski WA, Lowenfels AB, Boyle P, Maisonneuve P, Bueno de Mesquita HB, Ghadirian P, et al. Epidemiologic aspects of gallbladder cancer: a case-control study of the SEARCH Program of the International Agency for Research on Cancer. J Natl Cancer Inst. 1997;89(15):1132–8.PubMedCrossRefGoogle Scholar
  153. 153.
    Hsing AW, Gao YT, Han TQ, Rashid A, Sakoda LC, Wang BS, et al. Gallstones and the risk of biliary tract cancer: a population-based study in China. Br J Cancer. 2007;97(11):1577–82.PubMedPubMedCentralCrossRefGoogle Scholar
  154. 154.
    Zatonski W, La Vecchia C, Levi F, Negri E, Lucchini F. Descriptive epidemiology of gall-bladder cancer in Europe. J Cancer Res Clin Oncol. 1993;119(3):165–71.PubMedCrossRefGoogle Scholar
  155. 155.
    de Aretxabala X, Riedeman P, Burgos L, Roa I, Araya JC, Echeverria X, et al. Gallbladder cancer. Case-control study. Rev Med Chil. 1995;123(5):581–6.PubMedGoogle Scholar
  156. 156.
    Kuriyama S, Tsubono Y, Hozawa A, Shimazu T, Suzuki Y, Koizumi Y, et al. Obesity and risk of cancer in Japan. Int J Cancer. 2005;113(1):148–57.PubMedCrossRefGoogle Scholar
  157. 157.
    Engeland A, Tretli S, Austad G, Bjorge T. Height and body mass index in relation to colorectal and gallbladder cancer in two million Norwegian men and women. Cancer Causes Control. 2005;16(8):987–96.PubMedCrossRefGoogle Scholar
  158. 158.
    Ishiguro S, Inoue M, Kurahashi N, Iwasaki M, Sasazuki S, Tsugane S. Risk factors of biliary tract cancer in a large-scale population-based cohort study in Japan (JPHC study); with special focus on cholelithiasis, body mass index, and their effect modification. Cancer Causes Control. 2008;19(1):33–41.PubMedCrossRefGoogle Scholar
  159. 159.
    Jee SH, Yun JE, Park EJ, Cho ER, Park IS, Sull JW, et al. Body mass index and cancer risk in Korean men and women. Int J Cancer. 2008;123(8):1892–6.PubMedCrossRefGoogle Scholar
  160. 160.
    Song YM, Sung J, Ha M. Obesity and risk of cancer in postmenopausal Korean women. J Clin Oncol. 2008;26(20):3395–402.PubMedCrossRefGoogle Scholar
  161. 161.
    Borena W, Edlinger M, Bjorge T, Haggstrom C, Lindkvist B, Nagel G, et al. A prospective study on metabolic risk factors and gallbladder cancer in the metabolic syndrome and cancer (Me-Can) collaborative study. PLoS One. 2014;9(2):e89368.PubMedPubMedCentralCrossRefGoogle Scholar
  162. 162.
    Grainge MJ, West J, Solaymani-Dodaran M, Aithal GP, Card TR. The antecedents of biliary cancer: a primary care case-control study in the United Kingdom. Br J Cancer. 2009;100(1):178–80.PubMedCrossRefGoogle Scholar
  163. 163.
    Hsing AW, Sakoda LC, Rashid A, Chen J, Shen MC, Han TQ, et al. Body size and the risk of biliary tract cancer: a population-based study in China. Br J Cancer. 2008;99(5):811–5.PubMedPubMedCentralCrossRefGoogle Scholar
  164. 164.
    Machova L, Cizek L, Horakova D, Koutna J, Lorenc J, Janoutova G, et al. Association between obesity and cancer incidence in the population of the District Sumperk, Czech Republic. Onkologie. 2007;30(11):538–42.PubMedGoogle Scholar
  165. 165.
    Nakadaira H, Lang I, Szentirmay Z, Hitre E, Kaster M, Yamamoto M. A case-control study of gallbladder cancer in Hungary. Asian Pac J Cancer Prev. 2009;10(5):833–6.PubMedGoogle Scholar
  166. 166.
    Serra I, Yamamoto M, Calvo A, Cavada G, Baez S, Endoh K, et al. Association of chili pepper consumption, low socioeconomic status and longstanding gallstones with gallbladder cancer in a Chilean population. Int J Cancer. 2002;102(4):407–11.PubMedCrossRefGoogle Scholar
  167. 167.
    Strom BL, Soloway RD, Rios-Dalenz JL, Rodriguez-Martinez HA, West SL, Kinman JL, et al. Risk factors for gallbladder cancer. An international collaborative case-control study. Cancer. 1995;76(10):1747–56.PubMedCrossRefGoogle Scholar
  168. 168.
    Zhang XH, Gao YT, Rashid A, Deng J, Liu EJ, Wu K, et al. Tea consumption and risk of biliary tract cancers and gallstone disease: a population-based case-control study in Shanghai, China. Zhonghua Zhong Liu Za Zhi. 2005;27(11):667–71.PubMedGoogle Scholar
  169. 169.
    Park M, Song DY, Je Y, Lee JE. Body mass index and biliary tract disease: a systematic review and meta-analysis of prospective studies. Prev Med. 2014;65:13–22.PubMedCrossRefGoogle Scholar
  170. 170.
    Li L, Gan Y, Li W, Wu C, Lu Z. Overweight, obesity and the risk of gallbladder and extrahepatic bile duct cancers: a meta-analysis of observational studies. Obesity (Silver Spring). 2016;24(8):1786–802.CrossRefGoogle Scholar
  171. 171.
    Hariharan D, Saied A, Kocher HM. Analysis of mortality rates for pancreatic cancer across the world. HPB (Oxford). 2008;10(1):58–62.CrossRefGoogle Scholar
  172. 172.
    Cancer facts & figures. American Cancer Society; 2010.Google Scholar
  173. 173.
    Health. NCINIo. Pancreatic Cancer Treatment, Health Professional Version; 2014.Google Scholar
  174. 174.
    Larsson SC, Permert J, Hakansson N, Naslund I, Bergkvist L, Wolk A. Overall obesity, abdominal adiposity, diabetes and cigarette smoking in relation to the risk of pancreatic cancer in two Swedish population-based cohorts. Br J Cancer. 2005;93(11):1310–5.PubMedPubMedCentralCrossRefGoogle Scholar
  175. 175.
    Li D, Morris JS, Liu J, Hassan MM, Day RS, Bondy ML, et al. Body mass index and risk, age of onset, and survival in patients with pancreatic cancer. JAMA. 2009;301(24):2553–62.PubMedPubMedCentralCrossRefGoogle Scholar
  176. 176.
    Rollins KE, Tewari N, Ackner A, Awwad A, Madhusudan S, Macdonald IA, et al. The impact of sarcopenia and myosteatosis on outcomes of unresectable pancreatic cancer or distal cholangiocarcinoma. Clin Nutr. 2016;35(5):1103–9.PubMedCrossRefGoogle Scholar
  177. 177.
    Genkinger JM, Spiegelman D, Anderson KE, Bernstein L, van den Brandt PA, Calle EE, et al. A pooled analysis of 14 cohort studies of anthropometric factors and pancreatic cancer risk. Int J Cancer. 2011;129(7):1708–17.PubMedPubMedCentralCrossRefGoogle Scholar
  178. 178.
    Aune D, Greenwood DC, Chan DS, Vieira R, Vieira AR, Navarro Rosenblatt DA, et al. Body mass index, abdominal fatness and pancreatic cancer risk: a systematic review and non-linear dose-response meta-analysis of prospective studies. Ann Oncol. 2012;23(4):843–52.PubMedCrossRefGoogle Scholar
  179. 179.
    Majumder K, Gupta A, Arora N, Singh PP, Singh S. Premorbid obesity and mortality in patients with pancreatic cancer: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2016;14(3):355–68e; quiz e32.PubMedCrossRefGoogle Scholar
  180. 180.
    Dawson DW, Hertzer K, Moro A, Donald G, Chang HH, Go VL, et al. High-fat, high-calorie diet promotes early pancreatic neoplasia in the conditional KrasG12D mouse model. Cancer Prev Res (Phila). 2013;6(10):1064–73.CrossRefGoogle Scholar
  181. 181.
    Khasawneh J, Schulz MD, Walch A, Rozman J, Hrabe de Angelis M, Klingenspor M, et al. Inflammation and mitochondrial fatty acid beta-oxidation link obesity to early tumor promotion. Proc Natl Acad Sci U S A. 2009;106(9):3354–9.PubMedPubMedCentralCrossRefGoogle Scholar
  182. 182.
    Lashinger LM, Harrison LM, Rasmussen AJ, Logsdon CD, Fischer SM, McArthur MJ, et al. Dietary energy balance modulation of Kras- and Ink4a/Arf+/−-driven pancreatic cancer: the role of insulin-like growth factor-I. Cancer Prev Res (Phila). 2013;6(10):1046–55.CrossRefGoogle Scholar
  183. 183.
    Philip B, Roland CL, Daniluk J, Liu Y, Chatterjee D, Gomez SB, et al. A high-fat diet activates oncogenic Kras and COX2 to induce development of pancreatic ductal adenocarcinoma in mice. Gastroenterology. 2013;145(6):1449–58.PubMedCrossRefGoogle Scholar
  184. 184.
    Bethea TN, Kitahara CM, Sonderman J, Patel AV, Harvey C, Knutsen SF, et al. A pooled analysis of body mass index and pancreatic cancer mortality in African Americans. Cancer Epidemiol Biomark Prev. 2014;23(10):2119–25.CrossRefGoogle Scholar
  185. 185.
    Genkinger JM, Kitahara CM, Bernstein L, Berrington de Gonzalez A, Brotzman M, Elena JW, et al. Central adiposity, obesity during early adulthood, and pancreatic cancer mortality in a pooled analysis of cohort studies. Ann Oncol. 2015;26(11):2257–66.PubMedPubMedCentralCrossRefGoogle Scholar
  186. 186.
    Pecorelli N, Carrara G, De Cobelli F, Cristel G, Damascelli A, Balzano G, et al. Effect of sarcopenia and visceral obesity on mortality and pancreatic fistula following pancreatic cancer surgery. Br J Surg. 2016;103(4):434–42.PubMedCrossRefGoogle Scholar
  187. 187.
    Stolzenberg-Solomon RZ, Schairer C, Moore S, Hollenbeck A, Silverman DT. Lifetime adiposity and risk of pancreatic cancer in the NIH-AARP Diet and Health Study cohort. Am J Clin Nutr. 2013;98(4):1057–65.PubMedPubMedCentralCrossRefGoogle Scholar
  188. 188.
    Tan BH, Birdsell LA, Martin L, Baracos VE, Fearon KC. Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer. Clin Cancer Res. 2009;15(22):6973–9.CrossRefPubMedGoogle Scholar
  189. 189.
    Organization WH. Obesity and overweight fact. Sheet N311. Geneva; 2006.Google Scholar
  190. 190.
    Declaration IUACUWC. 2008.Google Scholar
  191. 191.
    Disease. GAftPoOaRC; 2008.Google Scholar
  192. 192.
    Christou NV, Lieberman M, Sampalis F, Sampalis JS. Bariatric surgery reduces cancer risk in morbidly obese patients. Surg Obes Relat Dis. 2008;4(6):691–5.PubMedCrossRefPubMedCentralGoogle Scholar
  193. 193.
    McCawley GM, Ferriss JS, Geffel D, Northup CJ, Modesitt SC. Cancer in obese women: potential protective impact of bariatric surgery. J Am Coll Surg. 2009;208(6):1093–8.PubMedCrossRefGoogle Scholar
  194. 194.
    Clough A, Layani L, Shah A, Wheatley L, Taylor C. Laparoscopic gastric banding in over 60s. Obes Surg. 2011;21(1):10–7.PubMedCrossRefGoogle Scholar
  195. 195.
    Forsell P, Hellers G. The Swedish Adjustable Gastric Banding (SAGB) for morbid obesity: 9 year experience and a 4-year follow-up of patients operated with a new adjustable band. Obes Surg. 1997;7(4):345–51.PubMedCrossRefGoogle Scholar
  196. 196.
    Gagne DJ, Papasavas PK, Maalouf M, Urbandt JE, Caushaj PF. Obesity surgery and malignancy: our experience after 1500 cases. Surg Obes Relat Dis. 2009;5(2):160–4.PubMedCrossRefGoogle Scholar
  197. 197.
    Gusenoff JA, Koltz PF, O’Malley WJ, Messing S, Chen R, Langstein HN. Breast cancer and bariatric surgery: temporal relationships of diagnosis, treatment, and reconstruction. Plast Reconstr Surg. 2009;124(4):1025–32.PubMedCrossRefGoogle Scholar
  198. 198.
    Ostlund MP, Lu Y, Lagergren J. Risk of obesity-related cancer after obesity surgery in a population-based cohort study. Ann Surg. 2010;252(6):972–6.PubMedCrossRefGoogle Scholar
  199. 199.
    Srikanth MS, Fox SR, Oh KH, Ward K, Sun H, Keskey T, et al. Renal cell carcinoma following bariatric surgery. Obes Surg. 2005;15(8):1165–70.PubMedCrossRefGoogle Scholar
  200. 200.
    Steffen R, Potoczna N, Bieri N, Horber FF. Successful multi-intervention treatment of severe obesity: a 7-year prospective study with 96% follow-up. Obes Surg. 2009;19(1):3–12.PubMedCrossRefGoogle Scholar
  201. 201.
    Sugerman HJ, Sugerman EL, Wolfe L, Kellum JM Jr, Schweitzer MA, DeMaria EJ. Risks and benefits of gastric bypass in morbidly obese patients with severe venous stasis disease. Ann Surg. 2001;234(1):41–6.PubMedPubMedCentralCrossRefGoogle Scholar
  202. 202.
    Birks S, Peeters A, Backholer K, O’Brien P, Brown W. A systematic review of the impact of weight loss on cancer incidence and mortality. Obes Rev. 2012;13(10):868–91.PubMedCrossRefGoogle Scholar
  203. 203.
    Casagrande DS, Rosa DD, Umpierre D, Sarmento RA, Rodrigues CG, Schaan BD. Incidence of cancer following bariatric surgery: systematic review and meta-analysis. Obes Surg. 2014;24(9):1499–509.PubMedCrossRefGoogle Scholar
  204. 204.
    Derogar M, Hull MA, Kant P, Ostlund M, Lu Y, Lagergren J. Increased risk of colorectal cancer after obesity surgery. Ann Surg. 2013;258(6):983–8.PubMedCrossRefGoogle Scholar
  205. 205.
    James WP, Caterson ID, Coutinho W, Finer N, Van Gaal LF, Maggioni AP, et al. Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects. N Engl J Med. 2010;363(10):905–17.PubMedCrossRefGoogle Scholar
  206. 206.
    Franco M, Bilal U, Ordunez P, Benet M, Morejon A, Caballero B, et al. Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980–2010: repeated cross sectional surveys and ecological comparison of secular trends. BMJ. 2013;346:f1515.PubMedCrossRefGoogle Scholar
  207. 207.
    DeMaria EJ, Pate V, Warthen M, Winegar DA. Baseline data from American Society for Metabolic and Bariatric Surgery-designated Bariatric Surgery Centers of excellence using the bariatric outcomes longitudinal database. Surg Obes Relat Dis. 2010;6(4):347–55.PubMedCrossRefGoogle Scholar
  208. 208.
    Renehan AG. Bariatric surgery, weight reduction, and cancer prevention. Lancet Oncol. 2009;10(7):640–1.PubMedCrossRefGoogle Scholar
  209. 209.
    Ashrafian H, Ahmed K, Rowland SP, Patel VM, Gooderham NJ, Holmes E, et al. Metabolic surgery and cancer: protective effects of bariatric procedures. Cancer. 2011;117(9):1788–99.PubMedCrossRefGoogle Scholar

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General SurgeryUniversity of Illinois Hospital and Health Sciences SystemChicagoUSA
  2. 2.Department of Surgery, Division of Surgical OncologyUniversity of Illinois at ChicagoChicagoUSA

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