Impact of obesity on cancer survivorship and the potential relevance of race and ethnicity

Kathryn H. Schmitz, Marian L. Neuhouser, Tanya Agurs-Collins, Krista A. Zanetti, Lisa Cadmus-Bertram, Lorraine T. Dean, Bettina F. Drake

Research output: Contribution to journalReview article

62 Citations (Scopus)

Abstract

Evidence that obesity is associated with cancer incidence and mortality is compelling. By contrast, the role of obesity in cancer survival is less well understood. There is inconsistent support for the role of obesity in breast cancer survival, and evidence for other tumor sites is scant. The variability in findings may be due in part to comorbidities associated with obesity itself rather than with cancer, but it is also possible that obesity creates a physiological setting that meaningfully alters cancer treatment efficacy. In addition, the effects of obesity at diagnosis may be distinct from the effects of weight change after diagnosis. Obesity and related comorbid conditions may also increase risk for common adverse treatment effects, including breast cancer-related lymphedema, fatigue, poor health-related quality of life, and worse functional health. Racial and ethnic groups with worse cancer survival outcomes are also the groups for whom obesity and related comorbidities are more prevalent, but findings from the few studies that have addressed these complexities are inconsistent. We outline a broad theoretical framework for future research to clarify the specifics of the biological-social-environmental feedback loop for the combined and independent contributions of race, comorbid conditions, and obesity on cancer survival and adverse treatment effects. If upstream issues related to comorbidities, race, and ethnicity partly explain the purported link between obesity and cancer survival outcomes, these factors should be among those on which interventions are focused to reduce the burden of cancer.

Original languageEnglish (US)
Pages (from-to)1344-1354
Number of pages11
JournalJournal of the National Cancer Institute
Volume105
Issue number18
DOIs
StatePublished - Sep 18 2013

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Survival Rate
Obesity
Neoplasms
Comorbidity
Ethnic Groups
Fatigue
Quality of Life
Breast Neoplasms
Weights and Measures
Mortality
Incidence
Health
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Schmitz, K. H., Neuhouser, M. L., Agurs-Collins, T., Zanetti, K. A., Cadmus-Bertram, L., Dean, L. T., & Drake, B. F. (2013). Impact of obesity on cancer survivorship and the potential relevance of race and ethnicity. Journal of the National Cancer Institute, 105(18), 1344-1354. https://doi.org/10.1093/jnci/djt223
Schmitz, Kathryn H. ; Neuhouser, Marian L. ; Agurs-Collins, Tanya ; Zanetti, Krista A. ; Cadmus-Bertram, Lisa ; Dean, Lorraine T. ; Drake, Bettina F. / Impact of obesity on cancer survivorship and the potential relevance of race and ethnicity. In: Journal of the National Cancer Institute. 2013 ; Vol. 105, No. 18. pp. 1344-1354.
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Schmitz, KH, Neuhouser, ML, Agurs-Collins, T, Zanetti, KA, Cadmus-Bertram, L, Dean, LT & Drake, BF 2013, 'Impact of obesity on cancer survivorship and the potential relevance of race and ethnicity', Journal of the National Cancer Institute, vol. 105, no. 18, pp. 1344-1354. https://doi.org/10.1093/jnci/djt223

Impact of obesity on cancer survivorship and the potential relevance of race and ethnicity. / Schmitz, Kathryn H.; Neuhouser, Marian L.; Agurs-Collins, Tanya; Zanetti, Krista A.; Cadmus-Bertram, Lisa; Dean, Lorraine T.; Drake, Bettina F.

In: Journal of the National Cancer Institute, Vol. 105, No. 18, 18.09.2013, p. 1344-1354.

Research output: Contribution to journalReview article

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AU - Schmitz, Kathryn H.

AU - Neuhouser, Marian L.

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AU - Cadmus-Bertram, Lisa

AU - Dean, Lorraine T.

AU - Drake, Bettina F.

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AB - Evidence that obesity is associated with cancer incidence and mortality is compelling. By contrast, the role of obesity in cancer survival is less well understood. There is inconsistent support for the role of obesity in breast cancer survival, and evidence for other tumor sites is scant. The variability in findings may be due in part to comorbidities associated with obesity itself rather than with cancer, but it is also possible that obesity creates a physiological setting that meaningfully alters cancer treatment efficacy. In addition, the effects of obesity at diagnosis may be distinct from the effects of weight change after diagnosis. Obesity and related comorbid conditions may also increase risk for common adverse treatment effects, including breast cancer-related lymphedema, fatigue, poor health-related quality of life, and worse functional health. Racial and ethnic groups with worse cancer survival outcomes are also the groups for whom obesity and related comorbidities are more prevalent, but findings from the few studies that have addressed these complexities are inconsistent. We outline a broad theoretical framework for future research to clarify the specifics of the biological-social-environmental feedback loop for the combined and independent contributions of race, comorbid conditions, and obesity on cancer survival and adverse treatment effects. If upstream issues related to comorbidities, race, and ethnicity partly explain the purported link between obesity and cancer survival outcomes, these factors should be among those on which interventions are focused to reduce the burden of cancer.

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