TMC PULSE

26 t m c » p u l s e | m a r c h 2 0 1 9 Obesity's Link to Cancer Texas has the highest mortality rate for liver cancer in the nation B y B r i t n i R . M c A s h a n F or years, health officials have warned Americans about the link between obesity and heart disease, diabetes and other chronic conditions. But a lesser known fact is that obesity is also linked to cancer. Adult obesity rates now exceed 35 percent in seven states, according to the State of Obesity report, an annual collaborative project of the Trust for America's Health and the Robert Wood Johnson Foundation. Texas has the 14th highest adult obesity rate in the country, 33 percent, and the seventh highest obesity rate among 10- to 17-year-olds, 18.5 percent. In a study funded by the American Cancer Society and National Cancer Institute that was published in The Lancet journal in early February, researchers also found that the risk of obesity-related cancers was significantly higher for young adults than the elderly. "Obesity and obesity-related cancers are a major problem not only in Texas, but around the country, because the obesity epidemic has skyrocketed," said Kent Osborne, M.D., director of the Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine. "The two that are most concerning here—they are still a little bit uncommon, but they are the most rapidly rising CANCERS ASSOCIATED WITH OBESITY cancers in Texas and nationally—are liver cancer and esophageal cancer." Texas has become the state with the highest mortality rate for liver cancer in the nation. "Several pockets around Texas, particularly border counties, have some rates that rival those of China. China has the highest rates of liver cancer in the world," said Hashem B. El-Serag, M.D., M.P.H., director of the Texas Medical Center Digestive Diseases Center and chair and pro- fessor of the Margaret M. and Albert B. Alkek Department of Medicine at Baylor College of Medicine. Recent data from the Texas Cancer Registry found that the incidence of liver cancer was 65 percent higher in the Houston metropolitan area compared to the nation overall. Every racial- ethic group included showed higher incidence of liver cancer compared to their counterparts around the country. "We compared all of the rates from the Houston metropolitan area to the U.S. and we looked at trends and what has changed over time," said Melissa Bondy, Ph.D., associate director of cancer prevention and population sciences at the Dan L Duncan Comprehensive Cancer Center. "We were interested in obesity because we know that obesity is a problem in our catchment area and it is related to multiple cancers. It is also a significant source of other chronic diseases." Because Texas is a multiethnic, multicul- tural state, the study was able to shine a light on the risk of liver cancer in different populations. Latinos, particularly in south Texas, have become the group with the highest risk of developing liver cancer, according to El-Serag. Thyroid Meningioma (cancer in the tissue covering the brain and spinal cord) Adenocarcinoma of the esophagus Multiple myeloma (cancer of blood cells) Endometrium (cancer in the tissue lining the uterus) Kidney Ovary Liver Gallbladder Upper stomach Pancreas Colon and rectum Breast (postmenopausal women) Source: Centers for Disease Control & Prevention The liver is a very resilient organ. It has a huge amount of reserve, which means that one can lose 80 to 90 percent of liver function without showing any signs or symptoms. — HASHEM B. EL-SERAG, M.D. Director of the Texas Medical Center Digestive Diseases Center and chair and professor of the Margaret M. and Albert B. Alkek Department of Medicine at Baylor College of Medicine

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