Friday, January 27, 2023
Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™
ABIM Diplomates - maximum of 0.25 ABIM MOC points
Nurses - 0.25 ANCC Contact Hour(s) (0 contact hours are in the area of pharmacology)
IPCE - 0.25 Interprofessional Continuing Education (IPCE) credit
This activity is intended for hematologists/oncologists, gastroenterologists, family medicine and primary care practitioners, internists, nurses, and other members of the healthcare team for patients with or at risk for gastrointestinal (GI) cancers.
The goal of this activity is for learners to be better able to describe the association between pre-obesity and obesity and the risk for GI cancer development in male and female patients, according to an analysis of the Disease Analyzer database (IQVIA), a large outpatient database from Germany.
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CME / ABIM MOC / CE Released: 4/8/2022
Valid for credit through: 4/8/2023
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Cancer is the second leading cause of death worldwide, implementing a major health care and socioeconomic burden. Overweight and obesity, both of which are dramatically on the rise in both highly and less developed regions worldwide, have been established as modifiable risk factors for the development of various tumor entities including gastrointestinal (GI) cancers such as colorectal or gastric cancer.
Several gastrointestinal (GI) cancers (e.g. colorectal, gastric, esophagus and liver cancer) are among the 10 most prevalent tumors worldwide in both sexes, and most have high morbidity and mortality. Primary prevention of cancer based on established risk factors is a leading strategy to reduce the high number of cancer-associated deaths worldwide.
In addition to genetic alterations associated with increased risk for cancer development, several modifiable risk factors for cancer have been identified in recent decades. Among these, overweight and obesity, which are dramatically on the rise in both highly and less developed regions worldwide, represent a crucial risk factor for cancer development. Although the underlying pathophysiological mechanism have not been fully elucidated today, several studies have proven an association between pre-obesity or obesity and an increased risk for cancer development for different cancer entities including post-menopausal breast cancer, cervix, and ovarian cancer and renal cell carcinoma. In line, there is a growing body of evidence suggesting an association between excessive body fat and the incidence of GI cancers such as colorectal cancer, gastric cancer, liver cancer, and pancreatic cancer.
Weight-related risk for GI cancers is driven in part by sex, a retrospective study of more than 287,000 outpatients in Germany suggests.
The results show, for instance, that obesity increases the risk for colon cancer in both men and women but increases the risk for rectal and liver cancers in men only.
"Our data suggest that obesity represents a decisive risk factor for the development of colon, rectal, and liver cancer, partly in a sex-dependent manner," Sven H. Loosen, MD, of Heinrich Heine University, Duesseldorf, Germany, and colleagues wrote.
The study was published February 13 in Cancers.[1]
Among 287,357 adults from the Disease Analyzers database, Loosen and colleagues compared the development of GI cancers in individuals with pre-obesity (body mass index [BMI] = 25-29 kg/m2) and obese (BMI ≥ 30 mg/m2) to that of individuals of normal weight (BMI = 18.5-24 kg/ m2).
For colon cancer, the authors observed a stepwise increase in the proportion of diagnoses, from 0.5% and 0.64% in women and men of normal weight, respectively, to 0.71% and 0.91% in women and men with obesity, respectively. In multivariable regression models, that translated to a significantly increased risk for colon cancer in women with obesity (odds ratio [OR] = 1.23 [95% CI: 1.03, 1.48]) and men with obesity (OR = 1.43 [95% CI: 1.17, 1.74]).
Multivariable regression models, however, showed that associations between obesity and rectal and liver cancers occurred only in men (ORs = 1.36 and 1.79, respectively).
Notably, the authors also observed a negative association between pre-obesity and stomach cancer in men (OR = 0.65) and obesity and pancreatic cancer in women (OR = 0.61).
In other words, women and men with excess body fat may be "protected" from developing these conditions, "highlighting the complexity of the association between BMI and cancer in the different sexes," the authors wrote.
These findings could have implications for prevention and lifestyle programs, the authors said.
"Since pre-obesity and obesity are modifiable risk factors, the current results may help to establish appropriate prevention and lifestyle programs to reduce the high morbidity and mortality of GI tumors in the future," they concluded.
They suggested that some "overweight patients might be presented in a specific interdisciplinary 'metabolic board' comprising oncologists and physicians specialized in preventive medicine."
No specific funding related to this study has been disclosed. The authors have disclosed no relevant financial relationships.
Cancers (Basel). 2022;14:931.[1]
