Obesity and cancer in america: From declining mortality to emerging challenges.

Abstract

e23072 Background: Obesity is a global epidemic linked to various health issues, including cancer. This study investigates temporal trends in cancer burden among obese individuals in the U.S., emphasizing its long-term public health impact. Understanding these trends is crucial for informing effective public health strategies and resource allocation. Methods: Using the Multiple-Causes of Death database from the CDC WONDER, we retrospectively analyzed annual age‐adjusted mortality rates (AAMR) per 100,000 population from 1999 to 2020 in cancer patients with obesity. Joinpoint v5.3 was utilized to assess average annual percent change (AAPC) and annual percent change (APC) across significant trends. Results: Between 1999 and 2020, 14,937,519 deaths were recorded among adults aged 25 and older due to obesity and cancer. The overall AAMR for cancer and obesity-related deaths decreased from 1999 to 2020 with an AAPC of -1.13 (95% CI: -1.27 to -1.06, p < 0.0001). The overall AAMR significantly declined from 1999 to 2018, followed by a non-significant increase until 2020 (APC:1.25, 95% CI: -0.63 to 1.97, p = 0.1332). Across ethnicities, AAMR rose from 2018 to 2020, with the steepest incline among the non-Hispanic (NH) American group or Alaskan native group (APC: 6.10; 95% CI: 0.27 to 10.20, p = 0.040), followed by Hispanics and NH Black. Cancer and obesity death rates were stable between all U.S. Census Regions. Midwest showed a decline from 1999 to 2018 (APC = -1.0; 95% CI: -1.4 to –0.7, p = 0.004) followed by a steep increase till 2020 (APC = 6.6; 95% CI: 1.3 to 9.4, p = 0.013). Similarly, for the West, a decline till 2018 (APC = -1.0; 95% CI: -1.2 to –1.0, p < 0.0001) followed by a steep increase to 268.5 in 2020 (APC = 5.4; 95% CI: 3.1 to 6.6, p < 0.0001) was recorded. States in the 90th percentile of Cancer and Obesity mortality included West Virginia, Kentucky, Mississippi, Oklahoma, and the District of Columbia, while those in the 10th percentile included Colorado, North Mexico, Arizona, Hawaii, and Utah. Conclusions: This study reveals a complex relationship between obesity and cancer mortality over time, highlighting disparities across demographics and regions. While AAMRs decreased until 2018, the subsequent increase warrants further investigation, especially in light of the COVID-19 pandemic. Further studies are needed to assess the cause-and-effect relationship between obesity and cancer, as well subgroup analysis regarding specific cancer types. Deaths and age-adjusted mortality rates (AAMRs) per 1,000,000 for cancer and obesity-related deaths of adults in the U.S. by race/ethnicity, 1999–2020. Variable Deaths (n) AAMR (95% CI) Overall 14937519 312 (311.8 - 312.2) Female 7078238 262.9 (262.7 - 263.1) Male 7859281 382 (381.7 - 382.3) Race/Ethnicity  NH American Indian 72842 268.8 (266.8 - 270.9)  NH Asian 342215 181.3 (180.7 - 181.9)  NH Black 1706340 377 (376.5 - 377.6)  NH White 11980392 319.7 (319.5 - 319.9)  Hispanic 2982146 289.5 (289.2 - 289.9)