Abstract IA43: Overview on obesity and cancer in diverse populations
Authors: Das Rina 
Published: October 2015

Abstract
Obesity is a serious and costly public health problem. In 2009-2010, more than one-third of U.S. adults (35.7%) and 17% of youth were reported to be obese. The epidemiological data suggest that obesity is markedly different among multiple racial and ethnic populations. According to the United States Centers for Disease Control and Prevention (CDC) reports, Non-Hispanic blacks have the highest age-adjusted rates of obesity (47.8%) followed by Hispanics (42.5%), non-Hispanic whites (32.6%), and non-Hispanic Asians (10.8%). Higher prevalence of adult obesity was found in the Midwest (29.5%) and the South (29.4%). Lower prevalence was observed in the Northeast (25.3%) and the West (25.1%). Research has shown that obesity is a major risk factor for cancer. The link of obesity is stronger in some cancer types –such as breast cancer after menopause, and cancers of the colon and rectum, pancreas, kidney, esophagus, and endometrium. Studies indicate more than two thirds of those diagnosed with cancer are overweight or obese. Recently American Society of Clinical Oncology (ASCO) reported that by 2030, almost a half million Americans may be diagnosed with obesity related cancers annually. Being obese appears to be a problem for cancer survivors as well. For cancer survivors, obesity can increase the risk of cancer recurrence, side effects from therapy and lower survival.
Disparities exist in the overall burden of cancer and vary significantly among various racial and ethnic populations. For example, according to CDC, death rates for cancer are highest among African Americans compared to other racial and ethnic populations. Although American White women have the highest incidence rate for breast cancer, African American women are most likely to die from the disease. African American women are more often diagnosed with breast cancer at an earlier age and with more aggressive disease and poor outcome when compared to Whites. African American men have the highest incidence rate for prostate cancer in the United States and are more than twice as likely as White men to die of the disease. There is a need to enhance our understanding about the causes of obesity and how they affect cancer health disparities among diverse populations.
There are a variety of factors such as lifestyle factors, behavior, environment, genetic and other factors that play a role in increasing the risk for obesity and developing cancer. Recent reports suggest that obesity could promote cancer through excess body fat that produces increased levels of various growth factors such as insulin and insulin-like growth factor (IGF-1), hormones such as estrogen, adipocytokine (leptin, adiponectin), and inflammation. Recently changes in the microbiome have also been implicated in promoting obesity and cancer. These factors may also play a role in cancer disparities among the underserved populations. There is growing evidence that cancer disparities are caused by a complex interplay of multiple factors such as socioeconomic status, environment, genetics, biology and access to care. A better understanding of these multiple factors that link obesity and cancer may guide in the development and implementation of effective solutions to ultimately reduce obesity and cancer health disparities.
The solution to this complex problem will require a comprehensive and coordinated approach that will promote effective interventions for prevention of obesity, increased efforts in education, use of policy and environmental changes to promote healthy lifestyle choices. Studies from several groups have revealed that eating a healthy diet, increasing physical activity, and maintaining a healthy weight are effective in not only reducing obesity, but also in reducing the chance of recurrence and increasing the likelihood of disease-free survival for a number of cancers. In addition, there is a need for educational efforts to increase public awareness of the links between obesity and cancer and obesity related challenges in cancer patients. The efforts to increase knowledge on benefits of behavior change, healthy eating and active living, can also help to reduce obesity and cancer prevalence, especially among diverse underserved populations. To address the obesity epidemic, there is clearly a need for more holistic transdisciplinary research approach to develop effective strategies to prevent and treat obesity and improve overall cancer outcomes.
Citation Format: Rina Das. Overview on obesity and cancer in diverse populations. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr IA43.