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Excess adiposity and gastrointestinal cancer
P O Coe1, D A O'Reilly, A G Renehan
1Institute of Cancer Sciences, University of Manchester, Manchester, UK.
The British Journal of Surgery
|September 17, 2014
Summary
Excess adiposity increases the risk of several gastrointestinal cancers. While body mass index (BMI) is a known risk factor, weight-reducing strategies show limited evidence for cancer prevention.
Area of Science:
- Gastroenterology
- Oncology
- Epidemiology
Background:
- Excess adiposity is a recognized risk factor for multiple gastrointestinal cancers.
- The clinical translation of epidemiological findings linking obesity to cancer risk remains unclear.
Purpose of the Study:
- To quantify the association between adiposity and gastrointestinal cancer risk.
- To evaluate the effectiveness of weight-reducing interventions in cancer prevention.
Main Methods:
- Systematic reviews and critical appraisals of existing literature.
- Updated analyses to assess cancer risk associations and the impact of weight-loss strategies.
Main Results:
- Body mass index (BMI) is linked to increased risk of esophageal adenocarcinoma, colorectal, liver, gallbladder, and pancreatic cancers.
- Central adiposity indices show associations with esophageal and colorectal cancer, but BMI remains a comparable predictor.
- Limited evidence supports significant gastrointestinal cancer risk reduction through weight-loss strategies.
Conclusions:
- While BMI is a risk factor for several GI cancers, evidence for risk reduction via weight loss is weak.
- Methodological limitations and lack of robust biomarkers hinder conclusive interpretation and future prevention trials.
- Future research should explore novel mechanisms like local ectopic fat and improved intermediary measurements.
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