Abstract
Obesity and type 2 diabetes have both been associated with increased cancer risk and are becoming increasingly prevalent. Metabolic abnormalities such as insulin resistance and dyslipidemia are associated with both obesity and type 2 diabetes and have been implicated in the obesity-cancer relationship. Multiple mechanisms have been proposed to link obesity and diabetes with cancer progression, including an increase in insulin/IGF-1 signaling, lipid and glucose uptake and metabolism, alterations in the profile of cytokines, chemokines, and adipokines, as well as changes in the adipose tissue directly adjacent to the cancer sites. This review aims to summarize and provide an update on the epidemiological and mechanistic evidence linking obesity and type 2 diabetes with cancer, focusing on the roles of insulin, lipids, and adipose tissue.
Highlights
An increase in obesity has been observed in children as well as adults, in both genders, and is prevalent in both developed and developing countries [1,2,3]
A study assessing the effect of adolescent obesity on cancer risk and mortality later in life found that Body mass index (BMI) at age 17 was associated with an increased overall risk of cancer in men, but not in women
In a recent evaluation of a cohort from the European Investigation into Cancer and Nutrition (EPIC) study, no association between circulating 27-HC levels and premenopausal breast cancer risk was found, and an inverse correlation was reported in postmenopausal women [222, 223]. These results suggest that the estrogen levels may influence the association between 27-HC and breast cancer risk and survival [224]
Summary
An increase in obesity has been observed in children as well as adults, in both genders, and is prevalent in both developed and developing countries [1,2,3]. The IARC assessed the cancer-preventative effect of the absence of excess adiposity Both organizations found adequate evidence supporting the association of excess body fatness with increased risk of esophageal adenocarcinoma, colon and rectal, liver, pancreatic, postmenopausal breast, endometrial, and renal cell cancer [15,16,17,18]. A study assessing the effect of adolescent obesity on cancer risk and mortality later in life found that BMI at age 17 was associated with an increased overall risk of cancer in men, but not in women. A large prospective cohort study following men and women over the course of 16 years found that being overweight or obese was associated with a higher risk of death from cancer [27] It has been noted that inconsistency exists regarding the relationship between obesity and increased cancer-specific mortality [15, 16, 28]. As discussed in subsequent sections, the metabolic dysfunction associated with insulin resistance may underlie the link between obesity and cancer
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