Obesity-Related Cancer Burden Varies Widely Among US States

Study finds at least a 1.5-fold difference between states with lowest and highest proportions of cancers related to obesity.

States vary widely in the proportions of cancers related to obesity, with at least a 1.5-fold difference between states with the highest and lowest proportions, according to a new study published in JAMA Oncology.

Similarly, a recent study showed that the prevalence of obesity and associated cancer burden has been increasing worldwide, with new data indicating that nearly 4% of all cancers globally can be attributed to excess body weight.

In the JAMA Oncology study, the researchers calculated the population attributable fraction (PAF) of incident cancer cases attributable to excess body weight among adults aged 30 years from 2011 to 2015 in all 50 states and the District of Columbia. Over this time span, the study showed that each year an estimated 37,650 cancer cases in men and 74,690 cancer cases in women were attributable to excess body weight.

Among men, the PAF ranged from 3.9% in Montana to 6% in Texas, according to the study. However, the PAF for women was approximately twice as high as for men, ranging from 7.1% in Hawaii to 11.4% in the District of Columbia. The researchers noted that states with the highest PAFs were mostly in the South and Midwest, as well as Alaska and the District of Columbia.

Although the proportion of obesity-related cancers varies, the study determined that excess body weight accounts for at least 1 in 17 incident cancers in each state. Additionally, the proportion was greater for some individual cancer types, with endometrial cancer ranging from a PAF of 36.5% in Hawaii to 54.9% in Mississippi.

“Broad implementation of known community- and individual-level interventions is needed to reduce access to and marketing of unhealthy foods (eg, through a tax on sugary drinks) and to promote and increase access to healthy foods and physical activity, as well as preventive care,” the researchers wrote.


Islami F, Sauer AG, Gapstur SM, et al. Proportion of cancer cases attributable to excess body weight by US state, 2011-2015. JAMA Oncology. 2018. Doi: 10.1001/jamaoncol.2018.5639

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