The carcinogen of excess weight

What if I told you our children were being exposed to a known carcinogen, and it was increasing with successively younger kids? If that carcinogen were a preservative in packaging or chemicals from industrial waste, there would be widespread outcry. But it’s neither of those things. It’s something far more dangerous, but that we’ve somehow accepted as no big deal. But the risk is very real. The carcinogen is excess weight.

Now a report from my colleagues at the American Cancer Society shares evidence the problem is worse than most of us realized.

The research — which was published in the medical journal Lancet Public Health — looked at how incidence rates were changing for 30 cancers using data from 67 percent of the U.S. population. They looked at rates for 12 cancers that we know are linked to overweight and obesity, and for 18 other common cancers that are not. Of the 12 weight-related cancers, 6 — including multiple myeloma, colorectal, uterine, gallbladder, kidney and pancreatic cancers — have all shown significant increases in incidence among younger folks compared to past generations at the same age. In comparison, only 2 of 18 cancers not linked to excess body weight showed similar increases: certain cancers of the stomach and leukemia.

Not to be lost in the discussion is the observation that cancers linked to smoking and HIV are on the decline, while cancers of the throat linked to HPV infection are also increasing in frequency.

What is even more disturbing about the new data is the observation that for the weight-related cancers, the risk is increasing among progressively younger people, mirroring an increase in overweight and obesity we’re seeing in the U.S. That reinforces the conclusion that something bad is happening, and that “something bad” is related to our increasing weight.

The authors point out that as of 2014 one out of three of children and adolescents are overweight or obese, while a stunning 78.2 percent of Americans between the ages of 20 and 74 are in a similar situation.  Those are incredible statistics that should have all of us very concerned.

These findings are unfortunately not unexpected.

In 2003, my colleagues at the American Cancer Society published a research paper in the New England Journal of Medicine which added to the evidence that cancer risks increased with excess body weight. Others have published similar findings. The new study reinforces that idea and adds to the mix the higher risk posed by excess weight in younger people. As with any carcinogen, exposure as a child is particularly dangerous.

The fact is, these warnings have not exactly received a lot of traction. The irony, of course, is the association between body weight cancer gets a fraction of the attention of other, much smaller risks. And as we all know, we as a society are getting larger, and are now dealing with all sorts of consequences. It’s not just about cancer: It’s also about hypertension, diabetes, heart disease, degenerative joint disease. The list goes on and on.

We can try to do something about this as individuals: We can try to eat more fruits and vegetables and less red and processed meat and other processed foods; we can try to be more active. But that is a challenge, particularly for people with limited means. Not enough of us can afford to shop, cook, and eat perfectly; even fewer of us can afford gym memberships, let alone a pricey indoor exercise bike.

More importantly: We must resolve to address these issues by instituting policies and programs to make healthy choices possible. If this were a chemical contaminant, we would come together as a nation to address it.  We need to have that level of resolve to undertake a nationwide initiative to get this epidemic under control.

Sadly, too many do not have the option of heeding the advice. I know from my own personal experience that it’s neither easy nor simple to reverse a lifetime of overeating and under-exercising. Try as I might, it is a personal battle that I must address every day. That’s not easy for me, and I am one of the fortunate ones who has the knowledge and the opportunity to make those changes. It may not be easy for you. Hence the need for us as a society to commit to taking control of the problem, especially for our younger generations, as demonstrated by this research.

I would emphasize here that the absolute risk of these cancers in young people are very small; however, the point of this data was something far more important: These rising numbers are loud in their impact. This risk will follow these generations as they age, when cancer risk becomes very real. The authors suggest this study is a bellwether and that we stand to lose many of the gains we have made over the past 25 years in reducing the burden of cancer in this country. Imagine that we emerge successful (although not successful enough) in reducing the scourge of tobacco only to see those gains wiped away in a sea of overweight and obesity.

We haven’t worked this hard to fail. We always work hard to succeed, to improve our lives. Now it is clearly the time to take on this challenge, to make a difference, and avoid what appears to be a looming catastrophe when it comes to a disease we all dread. And that disease is cancer.

If we heed this message, we can make a difference. If we don’t, we cannot say we were not forewarned.

J. Leonard Lichtenfeld is deputy chief medical officer, American Cancer Society. He blogs at Dr. Len’s Cancer Blog.

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