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September 2016

The Obesity Paradox and Mortality After Colorectal Cancer: A Causal Conundrum

Author Affiliations
  • 1Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom
  • 2Health eResearch Centre, Farr Institute, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
JAMA Oncol. 2016;2(9):1127-1129. doi:10.1001/jamaoncol.2016.0868

Excess body adiposity, commonly approximated as elevated body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), is an established risk factor for increased incidence of several adult cancer types.1 Worldwide, each year, almost a half-million new cancers are attributed to elevated BMI, of which breast, colorectal, and endometrial cancers account for two-thirds.2 By extension, elevated BMI at or after cancer diagnosis might be associated with a poor prognosis in obesity-related cancers, and indeed, a meta-analysis3 of 82 studies have found such associations for breast cancer. This is a key rationale for weight management strategies in cancer survivorship programs and endorsed by clinical guidelines, for example, those from the American Society for Clinical Oncology.4

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