Abstract
Cancer is the second leading cause of death worldwide, with 9.6 million people estimated to have died of cancer in 2018. Excess body fat deposition is a risk factor for many types of cancer. Men and women exhibit differences in body fat distribution and energy homeostasis regulation. This systematic review aimed to understand why sex disparities in obesity are associated with sex differences in the incidence of gastrointestinal cancers. Cancers of the esophagus, liver, and colon are representative gastrointestinal cancers, and obesity is a convincing risk factor for their development. Numerous epidemiological studies have found sex differences in the incidence of esophageal, liver, and colorectal cancers. We suggest that these sexual disparities are partly explained by the availability of estrogens and other genetic factors regulating inflammation, cell growth, and apoptosis. Sex differences in gut microbiota composition may contribute to differences in the incidence and phenotype of colorectal cancer. To establish successful practices in personalized nutrition and medicine, one should be aware of the sex differences in the pathophysiology and associated mechanisms of cancer development.
Highlights
We summarize sexual disparities in fat deposition and distribution associated with sex differences in the incidence of gastrointestinal cancers, including esophageal cancer, liver cancer, and colorectal cancer
A meta-analysis of 32 Genome-wide association studies (GWAS) found 14 loci significantly associated with waist–hip ratio (WHR), and sex-specific analyses indicated that 14 loci were significant in women, while only three loci were significant in men
The genetic correlation between WHR and esophageal adenocarcinoma was significant in men, suggesting that the accumulation of visceral adipose tissue (VAT), which is more abundant in men than in women, is positively associated with Esophageal cancer (EC) incidence [83]
Summary
The prevalence of severe obesity is higher in women than in men [7] Men and women exhibit distinctive body fat distributions, with such differences being mainly explained by the actions of gonadal hormones. The location of fat depots has received much attention in terms of explaining sex differences in the incidence of many diseases, including cancer. It is necessary to understand the actions and interactions of sex hormones and sex chromosomes in sex-specific body fat distribution, in association with obesity-related non-communicable diseases such as cardiovascular heart diseases, diabetes, and cancer. We summarize sexual disparities in fat deposition and distribution associated with sex differences in the incidence of gastrointestinal cancers, including esophageal cancer, liver cancer, and colorectal cancer
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