Quantifying Cancer Burden Attributable to Obesity: Highlighting the Disparities by Sex, Race, and Ethnicity in a Rural State with High Obesity and Cancer Burden.

Overweight and obesity is a complex, multifactorial disease that increases the risk of several cancers. The purpose of this study is to calculate the population-attributable fraction (PAF%) of obesity-associated cancer rates among adults from 2010-2019 in Arkansas by sex, race, and ethnicity. Obesity-associated cancer data for this period were obtained from the Arkansas Central Cancer Registry. The PAF% was calculated using obesity prevalence and global relative risks. Obesity prevalence data were gathered from the Arkansas Behavioral Risk Factor Surveillance System. Global relative risks for each obesity-associated cancer were gathered from large-scale epidemiological studies, meta-analyses, and systematic reviews in which body mass index (BMI) was ≥ 30 kg/m2. Obesity-attributable cancer age-adjusted incidence rates (AAIRs) were calculated by multiplying the obesity-associated cancer's AAIR by the estimated PAF%. Breast, esophageal adenocarcinoma, gallbladder, kidney, and liver obesity-associated cancers each had a PAF% greater than 25% by sex, race, and ethnicity. Arkansas non-Hispanic (NH) Black women were disproportionately impacted by obesity-attributable cancers, with a disparity driven primarily by the higher incidence of breast and other female-specific cancers. Findings suggest that targeted screening among those with BMI ≥ 30 kg/m2 could decrease the burden of obesity-associated and attributable cancers in Arkansas, particularly for breast and colorectal cancers.