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Epidemiology And Molecular Mechanisms Tying Obesity, Diabetes, And The Metabolic Syndrome With Cancer

Emily J Gallagher, Derek Leroith
Published 2013 · Medicine
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It is well recognized that the world is witnessing an epidemic of obesity and type 2 diabetes (T2D). Numerous studies have shown that both obesity and T2D are associated with an increased risk for developing many of the common epithelial cancers as well as an increased risk of cancer-related mortality. There are many factors that are commonly associated with obesity, T2D, and the metabolic syndrome; these include lifestyle factors such as diet and physical inactivity and biological factors such as abdominal obesity, increased inflammation, dyslipidemia, hyperglycemia, and altered hormone and adipokine levels. Human, animal, and in vitro cell studies have examined the potential contribution of many of these factors to the development and growth of multiple cancers. In this review, we will present the epidemiological evidence for this association and then discuss the multiple factors that may play a role in the increased cancer risk and mortality in individuals with obesity, T2D, and the metabolic syndrome. ### Obesity and cancer The World Health Organization classifies weight in adults based on BMI, and many studies examine the link between obesity and cancer using BMI as a measure of obesity. The Cancer Prevention Study II (CPS II) examined the risk of cancer mortality in obese men and women in the U.S. They reported that obesity is associated with a significant increase in mortality from multiple cancers, including esophageal, colorectal, liver, gallbladder, pancreatic, breast, endometrial, cervical, ovarian, renal, brain, kidney, and prostate cancer; non-Hodgkin lymphoma; and multiple myeloma (1). A subsequent meta-analysis of 221 datasets revealed an increased incidence of many similar tumors associated with increased BMI, as well as thyroid cancer in both men and women and malignant melanoma in men (2). It has been estimated that overall overweight and obesity cause ~20% of all cancer cases (3). The highest association is between obesity and endometrial …
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