Cancers Associated With Obesity and Risk Factors Among Women

Abstract and Introduction

Abstract

We used data from the US Cancer Statistics database to determine trends in cancer incidence, stratified by age, race, and ethnicity, among women aged 20 years or older during an 18-year study period (2001–2018). We limited analysis to cancers associated with 5 modifiable risk factors: tobacco use, excess body fat, alcohol consumption, insufficient physical activity, and human papillomavirus infection. The incidence of cancers associated with obesity have risen, particularly among women aged 20 to 49 years (vs ≥50 y) and among Hispanic women. Strategies that address obesity rates in these populations may help decrease cancer risk.

Table 1. Age-Specific Incidence and Trends in Modifiable Risk Factor–Associated Cancers Among US Women of All Races and Ethnicities Aged 20 Years or Older, Stratified by Age Group, United States Cancer Statistics, 2001–2018 ^a
Risk factor, by age group, y	Age-specific incidence, 2001–2018	Trend 1	Trend 2	Trend 3	Trend 4	2001–2018
Year	APC (95% CI)	Year	APC (95% CI)	Year	APC (95% CI)	Year	APC (95% CI)	AAPC (95% CI)
Obesity-associated cancers
20–49	47.21 to 61.40	2001–2009	3.16^b (2.90 to 3.42)	2009–2012	0.50 (−1.64 to 2.68)	2012–2015	2.08 (−0.05 to 4.25)	2015–2018	−1.93^c (−2.95 to −0.89)	1.58^b (1.10 to 2.07)
≥50	755.46 to 688.87	2001–2004	−2.52^c (−3.81 to −1.20)	2004–2018	−0.08 (−0.20 to 0.04)	—	—	—	—	−0.52^b (−0.75 to −0.29)
Alcohol consumption–associated cancers
20–49	84.27 to 84.85	2001–2008	0.58^b (0.35 to 0.80)	2008–2011	−1.33 (−2.96 to 0.32)	2011–2018	0.20 (−0.02 to 0.43)	—	—	0.09 (−0.20 to 0.37)
≥50	569.35 to 481.56	2001–2004	−3.48^b (−4.86 to −2.09)	2004–2011	−0.82^c (−1.29 to −0.34)	2011–2018	−0.01 (−0.37 to 0.34)	—	—	−0.96^b (−1.27 to −0.66)
Tobacco use–associated cancers
20–49	42.36 to 41.61	2001–2007	1.06^c (0.61 to 1.52)	2007–2013	−1.54^b (−2.12 to −0.95)	2013–2016	1.42 (−1.27 to 4.17)	—	—	−0.14 (−0.65 to 0.39)
≥50	527.09 to 441.52	2001–2008	−1.12^b (−1.26 to −0.97)	2008–2011	−2.16^c (−3.22 to −1.10)	2011–2016	−0.13 (−0.46 to 0.21)	2016–2018	−1.26^c (−2.28 to −0.23)	−1.03^b (−1.24 to −0.82)
Insufficient physical activity–associated cancers
20–49	14.98 to 18.06	2001–2008	1.16^c (0.69 to 1.64)	2008–2013	0.11 (−0.96 to 1.20)	2013–2016	4.59^c (1.23 to 8.06)	2016–2018	−2.17 (−5.28 to 1.04)	1.05^b (0.39 to 1.71)
≥50	567.99 to 502.58	2001–2004	−3.44^b (−4.81 to −2.05)	2004–2011	−0.42 (−0.89 to 0.05)	2011–2018	0.22 (−0.12 to 0.57)	—	—	−0.70^b (−1.00 to −0.39)
Human papillomavirus–associated cancers
20–49	13.81 to 11.60	2001–2009	−0.73^c (−1.13 to −0.33)	2009–2013	−2.44^c (−4.31 to −0.54)	2013–2016	2.14 (−1.72 to 6.15)	2016–2018	−3.44 (−7.15 to 0.42)	−0.96^c (−1.74 to −0.17)
≥50	28.78 to 29.67	2001–2004	−1.33^c (−2.34 to −0.30)	2004–2016	0.92^b (0.79 to 1.05)	2016–2018	1.37 (−3.03 to 0.33)	—	—	0.25 (0 to 0.50)

Table 1. Age-Specific Incidence and Trends in Modifiable Risk Factor–Associated Cancers Among US Women of All Races and Ethnicities Aged 20 Years or Older, Stratified by Age Group, United States Cancer Statistics, 2001–2018 ^a

Risk factor, by age group, y

Age-specific incidence, 2001–2018

Trend 1

Trend 2

Trend 3

Trend 4

2001–2018

Year

APC (95% CI)

Year

APC (95% CI)

Year

APC (95% CI)

Year

APC (95% CI)

AAPC (95% CI)

Obesity-associated cancers

20–49

47.21 to 61.40

2001–2009

3.16^b (2.90 to 3.42)

2009–2012

0.50 (−1.64 to 2.68)

2012–2015

2.08 (−0.05 to 4.25)

2015–2018

−1.93^c (−2.95 to −0.89)

1.58^b (1.10 to 2.07)

≥50

755.46 to 688.87

2001–2004

−2.52^c (−3.81 to −1.20)

2004–2018

−0.08 (−0.20 to 0.04)

—

−0.52^b (−0.75 to −0.29)

Alcohol consumption–associated cancers

20–49

84.27 to 84.85

2001–2008

0.58^b (0.35 to 0.80)

2008–2011

−1.33 (−2.96 to 0.32)

2011–2018

0.20 (−0.02 to 0.43)

—

0.09 (−0.20 to 0.37)

≥50

569.35 to 481.56

2001–2004

−3.48^b (−4.86 to −2.09)

2004–2011

−0.82^c (−1.29 to −0.34)

2011–2018

−0.01 (−0.37 to 0.34)

—

−0.96^b (−1.27 to −0.66)

Tobacco use–associated cancers

20–49

42.36 to 41.61

2001–2007

1.06^c (0.61 to 1.52)

2007–2013

−1.54^b (−2.12 to −0.95)

2013–2016

1.42 (−1.27 to 4.17)

—

−0.14 (−0.65 to 0.39)

≥50

527.09 to 441.52

2001–2008

−1.12^b (−1.26 to −0.97)

2008–2011

−2.16^c (−3.22 to −1.10)

2011–2016

−0.13 (−0.46 to 0.21)

2016–2018

−1.26^c (−2.28 to −0.23)

−1.03^b (−1.24 to −0.82)

Insufficient physical activity–associated cancers

20–49

14.98 to 18.06

2001–2008

1.16^c (0.69 to 1.64)

2008–2013

0.11 (−0.96 to 1.20)

2013–2016

4.59^c (1.23 to 8.06)

2016–2018

−2.17 (−5.28 to 1.04)

1.05^b (0.39 to 1.71)

≥50

567.99 to 502.58

2001–2004

−3.44^b (−4.81 to −2.05)

2004–2011

−0.42 (−0.89 to 0.05)

2011–2018

0.22 (−0.12 to 0.57)

—

−0.70^b (−1.00 to −0.39)

Human papillomavirus–associated cancers

20–49

13.81 to 11.60

2001–2009

−0.73^c (−1.13 to −0.33)

2009–2013

−2.44^c (−4.31 to −0.54)

2013–2016

2.14 (−1.72 to 6.15)

2016–2018

−3.44 (−7.15 to 0.42)

−0.96^c (−1.74 to −0.17)

≥50

28.78 to 29.67

2001–2004

−1.33^c (−2.34 to −0.30)

2004–2016

0.92^b (0.79 to 1.05)

2016–2018

1.37 (−3.03 to 0.33)

—

0.25 (0 to 0.50)

Table 2. Cases of Modifiable Risk Factor–Associated Cancers Among US Women of All Races and Ethnicities Aged 20 Years or Older, Stratified by Age Group, United States Cancer Statistics, 2001–2018
Cancer type	No. (%)
Women aged 20–49 years (n = 1,775,965)	Women aged ≥50 years (n = 9,422,556)
Acute myeloid leukemia	18,397 (1.0)	82,486 (0.9)
Anal and rectal squamous cell carcinoma	10,253 (0.6)	57,772 (0.6)
Cervix uteri	117,023 (6.6)	112,751 (1.2)
Colon and rectum	124,086 (7.0)	1,142,756 (12.1)
Corpus and uterus not otherwise specified	107,759 (6.1)	735,174 (7.8)
Esophagus	3,305 (0.2)	59,835 (0.6)
Female breast	798,605 (45.0)^a	3,206,778 (34.0)^b
Gallbladder	2,697 (0.2)	43,689 (0.5)
Gastric cardia	2,372 (0.1)	24,742 (0.3)
Kidney	50,317 (2.8)	306,478 (3.2)
Larynx	4,899 (0.3)	41,132 (0.4)
Lip, oral cavity, and pharynx	30,551 (1.7)	175,233 (1.9)
Liver	6,803 (0.4)	95,093 (1.0)
Meningioma	730 (0.04)	3,246 (0.03)
Multiple myeloma	11,051 (0.6)	156,691 (1.7)
Oropharyngeal squamous cell carcinoma	6,907 (0.4)	47,708 (0.5)
Ovary	69,151 (3.9)	314,297 (3.3)
Pancreas	18,837 (1.1)	349,564 (3.7)
Stomach	18,269 (1.0)	137,278 (1.5)
Thyroid	263,292 (14.8)	259,595 (2.8)
Trachea, lung, and bronchus	83,421 (4.7)	1,712,034 (18.2)
Urinary bladder	14,641 (0.8)	292,400 (3.1)
Vaginal squamous cell carcinoma	1,784 (0.1)	12,621 (0.1)
Vulvar squamous cell carcinoma	10,815 (0.6)	53,203 (0.6)

Table 2. Cases of Modifiable Risk Factor–Associated Cancers Among US Women of All Races and Ethnicities Aged 20 Years or Older, Stratified by Age Group, United States Cancer Statistics, 2001–2018

Cancer type

No. (%)

Women aged 20–49 years (n = 1,775,965)

Women aged ≥50 years (n = 9,422,556)

Acute myeloid leukemia

18,397 (1.0)

82,486 (0.9)

Anal and rectal squamous cell carcinoma

10,253 (0.6)

57,772 (0.6)

Cervix uteri

117,023 (6.6)

112,751 (1.2)

Colon and rectum

124,086 (7.0)

1,142,756 (12.1)

Corpus and uterus not otherwise specified

107,759 (6.1)

735,174 (7.8)

Esophagus

3,305 (0.2)

59,835 (0.6)

Female breast

798,605 (45.0)^a

3,206,778 (34.0)^b

Gallbladder

2,697 (0.2)

43,689 (0.5)

Gastric cardia

2,372 (0.1)

24,742 (0.3)

Kidney

50,317 (2.8)

306,478 (3.2)

Larynx

4,899 (0.3)

41,132 (0.4)

Lip, oral cavity, and pharynx

30,551 (1.7)

175,233 (1.9)

Liver

6,803 (0.4)

95,093 (1.0)

Meningioma

730 (0.04)

3,246 (0.03)

Multiple myeloma

11,051 (0.6)

156,691 (1.7)

Oropharyngeal squamous cell carcinoma

6,907 (0.4)

47,708 (0.5)

Ovary

69,151 (3.9)

314,297 (3.3)

Pancreas

18,837 (1.1)

349,564 (3.7)

Stomach

18,269 (1.0)

137,278 (1.5)

Thyroid

263,292 (14.8)

259,595 (2.8)

Trachea, lung, and bronchus

83,421 (4.7)

1,712,034 (18.2)

Urinary bladder

14,641 (0.8)

292,400 (3.1)

Vaginal squamous cell carcinoma

1,784 (0.1)

12,621 (0.1)

Vulvar squamous cell carcinoma

10,815 (0.6)

53,203 (0.6)

Trends in Incidence of Cancers Associated With Obesity and Other Modifiable Risk Factors Among Women, 2001–2018

Abstract and Introduction

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