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Main Finding: Cancer-specific mortality related too obesity has significantly increased over the past two decades in the US.
Key statistics:
Tripling of Mortality: The overall age-adjusted mortality rate for obesity-associated cancers increased from 3.73 per million in 1999 to 13.52 per million in 2020, which is more than a tripling. Steeper Increase: This rise is steeper than many other chronic disease mortality trends during the same period.
Recent Increase: The average percent change from 2018-2020 was +19.4%.
Annual Increase: The average annual percentage change was a statistically meaningful 5.92%.
Cancers Associated with Obesity:
Obesity is linked to a higher risk for 13 specific cancers, which account for 40% of all US cancer diagnoses:
Adenocarcinoma of the esophagus
Postmenopausal breast cancer
Colon and rectum cancer
Uterus cancer
Gallbladder cancer
Upper stomach cancer
Kidney cancer
Liver cancer
Ovary cancer
Pancreas cancer
Thyroid cancer
Meningioma
Multiple myeloma
Demographic Disparities in Mortality Rates:
Gender: Higher in women than men (7.22 vs 6.59 per million).
Race/Ethnicity: Higher in non-Hispanic Black persons than non-Hispanic White persons (9.20 vs 7.13 per million). Age: significantly higher in adults aged 65+ compared to those aged 25-64 (20.82 vs 3.54 per million).
geography: Higher in rural areas than urban areas (9.45 vs 6.40 per million).
Region: Highest rates in the Midwest, lowest in the Northeast.
States: Vermont,Minnesota,and Oklahoma had the highest rates; utah,Alabama,and Virginia had the lowest.
Expert Opinions and Recommendations:
Lead Investigator: Faizan Ahmed, MD, from Jersey Shore University Medical Center.
Underappreciated link: The link between obesity and cancer mortality is often underappreciated. Call to Action for Clinicians: Clinicians should recognize obesity as a significant oncologic concern,not just a cardiovascular or metabolic risk factor. Weight management counseling should be reframed as a critical component of reducing long-term cancer risk. Socioeconomic Factors: Socioeconomic factors, access to care, delays in diagnosis, environmental exposures, and cultural factors likely contribute to the observed disparities across gender and race.
Policy Recommendations: Policy initiatives should shift from downstream management to upstream prevention, including:
Worldwide access to cancer screening programs.
Public health campaigns normalizing obesity management for cancer prevention.
Policies promoting equitable access to healthy foods and physical activity.
Context:
40% of US adults are living with obesity.
* The research was presented at ENDO 2025, The Endocrine Society annual Meeting.
