Islami F, et al. - Among adults 30 years or older in 2011 to 2015 in all 50 states and the District of Columbia, researchers calculated the population attributable fraction (PAF) of incident cancer cases attributable to excess body weight (EBW). This nationwide cross-sectional study of US adults found that the proportion of EBW-related cancers varies between states, but EBW accounts for at least 1 in 17 of all incident cancers in each state. The findings suggested that a wide range of known community and individual interventions are required 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.

Methods

• Using objectively measured body mass index (BMI) values from the National Health and Nutrition Examination Survey, state-level, self-reported BMI [calculated as weight in kilograms divided by height in meters squared] data from the Behavioral Risk Factor Surveillance System were adjusted by sex, age, race/ethnicity, and education.
• From the US Cancer Statistics database, age- and sex-specific cancer incidence data by state were obtained.
• Between February 15, 2018, and July 17, 2018, all analyses were performed.
• To compute the PAFs for each US state for esophageal adenocarcinoma, multiple myeloma, and cancers of the gastric cardia, colorectum, liver, gallbladder, pancreas, female breast, corpus uteri, ovary, kidney and renal pelvis, and thyroid, sex-, age-, and state-specific adjusted prevalence estimates for 4 high BMI categories and corresponding relative risks from large-scale pooled analyses or meta-analyses were used.

Results

• An estimated 37,670 cancer cases in men (4.7% of all cancer cases excluding nonmelanoma skin cancers) and 74,690 cancer cases in women (9.6%) 30 years or older in the US were attributable to EBW from 2011 to 2015 each year.
• There was at least a 1.5-fold difference in the proportions of cancers attributable to EBW between states with the highest and lowest PAFs in both men and women.
• The PAF ranged from 3.9% (95% CI, 3.6%-4.3%) in Montana to 6.0% (95% CI, 5.6%-6.4%) in Texas among men.
• For women, PAF, ranged from 7.1% (95% CI, 6.7%-7.6%) in Hawaii to 11.4% (95% CI, 10.7%-12.2%) in the District of Columbia, approximately twice as high as for men.
• The largest PAFs were mainly found in southern and midwestern states, Alaska and the District of Columbia.