Increasing Cancer Incidence in Young Adults Linked to Obesity

Cancer is known to be generally a disease of older age . However, some cancers have become more common in young adults in recent years. A new study suggests obesity may be the reason.

On 23 March 2018, Obesity published a study whose coauthor, Professor of Experimental Medicine Nathan A. Berger, stated that because overweight and obesity have become the biggest public health problem worldwide, cancer is also increasing among young adults.

With the global obesity epidemic, obesity-associated cancers in people younger than 50 may show a substantial increase .

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Obesity is known to be associated not only with increased incidence of certain cancers but also with a worse disease course (prognosis) in cancer patients with obesity.

Real Risks Are Overshadowed by Artificially Created or Much Smaller Risks

Even in Western societies, fewer than 50% of people know about the obesity-cancer link, and there is no meaningful study of the proportion of doctors aware of it. The public is continually distracted by different diets' or chemicals' potential to cause or prevent cancer. Yet regardless of diet, obesity itself is far more important for cancer risk than the contents of any eating pattern.

People know obesity is associated with cardiovascular disease, diabetes and even knee joint health, but awareness that it accelerates and promotes cancer development has not yet become established.

Overweight and obesity are associated with the following cancer types.

As obesity rates rose, young adults' risks increased for colon and rectal, thyroid, esophageal, pancreatic, kidney, breast, uterine (endometrial) and gallbladder cancers. People with obesity in adolescence were found to have increased risk of one of the common cancers, colon cancer , by age 48, amounting to a 1.5-fold increase.

To establish the obesity-cancer relationship, researchers searched PubMed and Google databases and found evidence linking young-adult cancer with body mass index ≥ 30-defined obesity in more than 100 publications.

How Does Obesity Increase Cancer Risk?

This review notes that obesity accelerates cancer development through the following pathways:

• Increased proinflammatory cytokine levels in obesity stimulate chronic inflammation and oxidative stress.
• Metabolic syndrome and insulin resistance involve increased insulin and insulin-like growth factor, with growth-promoting effects.
• Increased fatty tissue in people with obesity produces aromatase, altering sex steroid hormones (increasing conversion of androgens to estrogens).
• It alters adipocytokine proteins, increases growth-promoting and proinflammatory components such as leptin, retinol-binding protein 4, resistin and visfatin, and reduces growth-controlling adipokines such as adiponectin.
• By increasing tumor-promoting organisms such as Fusobacterium, it changes the intestinal microbiome (flora) .
• Obesity can also cause hiatal hernia (diaphragmatic hernia) and gastroesophageal reflux disease, which may predispose to esophageal cancer.

This study should clearly provide another incentive to keep children at a healthy weight. People used to say, "they are only young children and will lose the weight during an adolescent growth spurt"; we now know this is not a good thing. Pediatricians in particular should recognize that normal weight matters throughout life.

Obesity Supports Cancer Through Multiple Pathways Simultaneously.

If one pathway is successfully blocked, obesity-related cancer takes another. Therefore, obesity itself should be tackled directly rather than only its consequences.

An Advertising Ban to Protect Our Children in the Fight Against Obesity

In a very positive development, advertising of nutritionally unsuitable products was banned from the start of 2018. These include carbonated and sugary drinks, chips, confectionery and even modeling clay... Their advertisements will no longer appear on children's channels or TV programs targeting those under 12.

The Ministry of Customs and Trade met Türkiye's 12 largest food companies to combat obesity effectively. The National Food and Beverage Alliance Türkiye Pledge was created, adopting new policies for all marketing communication, including advertising, of food products.

Advertisements in other media will promote adequate, balanced nutrition and physical activity.

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