Islami F, et al. - In this study, investigators estimated the population attributable fraction (PAF) of incident cancer cases attributable to excess body weight (EBW) among individuals aged ≥ 30 in all 50 US states and the District of Columbia. In all, they observed the necessity of broad implementation of known community- and individual-level interventions to overcome access to, and marketing of, unhealthy foods. They also suggested encouraging and expanding access to healthy foods and physical activity along with preventive care.

Methods

• Investigators adjusted state-level, self-reported BMI data from the Behavioral Risk Factor Surveillance System by age, sex, race/ethnicity, and education via objectively measured BMI values from the National Health and Nutrition Examination Survey.
• They obtained age- and sex-specific cancer incidence data by state from the US Cancer Statistics database.
• They performed all the analyses between February 15, 2018, and July 17, 2018.
• The main outcomes and measures included sex-, age-, and state-specific adjusted prevalence estimates for four high BMI categories. Corresponding relative risks from large-scale, pooled analyses or meta-analyses were used to calculate 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.

Results

• An estimated 37,670 cancer cases in men (4.7% of all cancer cases except nonmelanoma skin cancers) and 74,690 cancer cases in women (9.6%) aged ≥ 30 years were attributable to EBW in the United States annually from 2011 to 2015.
• They noted a ≥ 1.5-fold difference in the proportions of cancers attributable to EBW between states with the highest and lowest PAFs in males and females.
• PAF ranged from 3.9% in Montana to 6.0% in Texas among men.
• They found that PAF for females was almost double for men, ranging from 7.1% in Hawaii to 11.4% in the District of Columbia.
• They observed the largest PAFs mostly in southern and midwestern states, as well as Alaska and the District of Columbia.