1. Public Health, Cancer, and Obesity
Cancer rates are on the rise across the world, making the illness a public health crisis, particularly in developed countries where cancer has become a leading cause of death [ 1 ]. Despite a rise in the incidence of most cancers, lung cancer has been declining in recent years in the USA following public awareness of its association with tobacco smoking [ 2 ]. People have been choosing not to smoke to lower the risk of getting lung cancer. If it has worked for lung cancer, public awareness of other preventable cancer risk factors, notably obesity, should then successfully protect people from the related cancers. However, the obesity and cancer issue is complex, partly because of biological differences among people and also the possibility of an obesity stigma along with raising public awareness of obesity and cancer [ 3 , 4 ].
2. Obesity and Cancer
Obesity has been on the rise across the world, particularly in developed countries [ 5 ]. Being overweight or obese has been associated with a higher risk of getting 13 types of cancer [ 6 , 7 ]. These 13 types constitute 40% of all cancers diagnosed in the United States each year and are: adenocarcinoma of the esophagus, breast (in women who have gone through menopause), colon and rectum, uterus, gallbladder, upper stomach, kidneys, liver, ovaries, pancreas, thyroid, meningioma (a type of brain cancer), and multiple myeloma [ 6 , 7 ]. According to a World Health Organization (WHO) report, 30–50% of all cancer cases are preventable [ 8 ], and addressing preventable factors offers a long-term strategy for the control of cancer [ 9 ].
3. Public Awareness, Cancer, Obesity
Despite the association of obesity with cancer, public awareness of this association is low. A study in the UK has shown it as low as 25.4% among unprompted and 57.5% among prompted respondents [ 10 ]. One intervention for raising awareness of obesity and cancer can be through mass media. However, we should consider avoiding the obesity stigma, a situation that can cause mental health and other problems even in the workplace [ 3 ]. Actually, it might be more complicated to raise public awareness against obesity-related cancers than smoking-related cancers partly because of the reality of obesity stigma. The prevailing media messages that blame obese people for being lazy, weak-willed, and unsuccessful need to be replaced with messages that obesity is a chronic disease with a complex etiology [ 4 ], and advertisements should be further designed by a team of specialists from different areas.
4. Targeted Awareness, Cancer, and Obesity
Another intervention for fighting against obesity is raising the awareness of obesity and cancer among patients. A report from the UK in a sample of patients, weighted to be representative of the UK population aged 18+, indicated that only 17.4% of patients received advice about their weight, although 48.4% of the sample were overweight/obese [ 10 ]. Hypothetically, an effective way of fighting obesity-related cancers, while avoiding obesity stigma, can be a targeted approach to reach obese patients who are consulting health providers for other reasons. Today’s problem for a patient may not be related to obesity, but tomorrow’s problem might be. The effects on obese people by COVID-19 can be an example of their vulnerability to a range of illnesses [ 11 ], and health providers should open a recurring discussion with patients about obesity-related health cancers during routine consultations to prevent problems in the future.
5. Obesity and Cancer: A Complex Issue
In addition to raising awareness and educating people (individual level), public health issues should be addressed at other levels, such as community and policy levels and governmental initiatives [ 12 ]. For example, promoting exercise by providing a safe environment for jogging can be another intervention to reduce the obesity rate [ 13 ]. The complexity of fighting obesity might be partly the reason for the failure in fighting against the rising obesity rate. It should be noted that, in addition to an increased risk of certain cancers, obesity can drastically worsen the quality of life for cancer patients. Obese patients with cancer are frequently offered less supportive care, notably palliative care, which might be partly due to difficulty in helping overweight patients with their movements [ 14 ]. Therefore, public health professionals should come up with plans to address obesity to not only reduce cancer rates but also improve the quality of life.
6. Conclusions
Many known and unknown factors are associated with cancer. Education and awareness of preventable factors, notably obesity, as well as other interventions can be a vital step to lowering the risk of getting cancer. Health providers should target their communications with obese patients toward keeping a healthy weight even if patients’ current illnesses may not be related to obesity. Health providers should take advantage of public knowledge of COVID-19 and obesity to remind patients about the importance of a healthy weight. While considering the stigma of obesity, public awareness of obesity and cancer through mass media is another intervention. Community- and policy-level interventions should be taken into account as well. Fighting obesity-related cancers can be complex, but it should be urgently and vigorously addressed before the problem gets worse.
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Author Contributions
Both others were involved in conceptualization, investigation, writing the original draft, and reviewing and editing of the final manuscript. All authors have read and agreed to the published version of the manuscript.
Conflicts of Interest
The authors declare no conflict of interest.
References
1. Hulvat M.C. Cancer Incidence and Trends Surg. Clin. 2020 100 469 481 10.1016/j.suc.2020.01.002 32402294
2. de Groot P.M. Wu C.C. Carter B.W. Munden R.F. The epidemiology of lung cancer Transl. Lung Cancer Res. 2018 7 220 233 10.21037/tlcr.2018.05.06 30050761 PMC6037963
3. Cohen R. Shikora S. Fighting Weight Bias and Obesity Stigma: A Call for Action Obes. Surg. 2020 30 1623 1624 10.1007/s11695-020-04525-0 32193742
4. Puhl R.M. Heuer C.A. Obesity stigma: Important considerations for public health Am. J. Public Health 2010 100 1019 1028 10.2105/AJPH.2009.159491 20075322 PMC2866597
5. Cheung P.C. Cunningham S.A. Narayan K.V. Kramer M. Childhood Obesity Incidence in the United States: A Systematic Review Child. Obes. 2016 12 1 11 10.1089/chi.2015.0055 26618249 PMC4753627
6. The Centers for Disease Control and Prevention Obesity and Cancer 2022 Available online: https://www.cdc.gov/cancer/obesity/index.htm (accessed on 20 May 2022)
7. Friedenreich C.M. Ryder-Burbidge C. McNeil J. Physical activity, obesity and sedentary behavior in cancer etiology: Epidemiologic evidence and biologic mechanisms Mol. Oncol. 2020 15 790 800 10.1002/1878-0261.12772 32741068 PMC7931121
8. The World Health Organization Preventing Cancer 2022 Available online: https://www.who.int/activities/preventing-cancer (accessed on 19 May 2022)
9. Bolourian A. Mojtahedi Z. Streptomyces, shared microbiome member of soil and gut, as ‘old friends’ against colon cancer FEMS Microbiol. Ecol. 2018 94 fiy120 10.1093/femsec/fiy120 29912397
10. Hooper L. Anderson A.S. Birch J. Forster A.S. Rosenberg G. Bauld L. Vohra J. Public awareness and healthcare professional advice for obesity as a risk factor for cancer in the UK: A cross-sectional survey J. Public Health 2017 40 797 805 10.1093/pubmed/fdx145 PMC6306085 29155951
11. Bolourian A. Mojtahedi Z. Obesity and COVID-19: The mTOR pathway as a possible culprit Obes. Rev. 2020 21 e13084 10.1111/obr.13084 32578354 PMC7362054
12. Gittelsohn J. Trude A.C. Poirier L. Ross A. Ruggiero C. Schwendler T. Steeves E.A. The Impact of a Multi-Level Multi-Component Childhood Obesity Prevention Intervention on Healthy Food Availability, Sales, and Purchasing in a Low-Income Urban Area Int. J. Environ. Res. Public Health 2017 14 1371 10.3390/ijerph14111371 29125558 PMC5708010
13. Roberts J.D. Rodkey L. Grisham C. Ray R. The influence of family dog ownership and parental perceived built environment measures on children’s physical activity within the Washington, DC Area Int. J. Environ. Res. Public Health 2017 14 1398 10.3390/ijerph14111398 29144433 PMC5708037
14. Subramoney K. Orman E. Johnson A.W. Kara A. The Impact of Obesity in End of Life Care in Patients With End Stage Liver Disease: An Observational Study Am. J. Hosp. Palliat. Med. 2020 38 1177 1181 10.1177/1049909120978768 33280394