Obesity-Related Cancer Deaths More Than Triple

Cancer deaths related to obesity have risen sharply over the past two decades, especially among older adults, women, non-Hispanic Black individuals and people living with obesity in rural areas, a US study found.

“Obesity is a well-known risk factor for various cancers, but its contribution to cancer-specific mortality over time hasn’t been systematically quantified at a national level,” lead investigator Faizan Ahmed, MD, with Jersey Shore University Medical Center, Neptune City, New Jersey, told Medscape Medical News.

“Clinicians should recognize obesity not just as a cardiovascular or metabolic risk factor but as a significant oncologic concern,” Ahmed said.

He presented his research on July 13 at ENDO 2025, The Endocrine Society Annual Meeting in San Francisco.

Higher Risk for 13 Cancers

According to the CDC, 40% of adults are living with obesity. Obesity is associated with a higher risk for 13 cancers, which make up 40% of all cancers diagnosed in the US each year.

They are adenocarcinoma of the esophagus, postmenopausal breast cancer, as well as cancer of the colon and rectum, uterus, gallbladder, upper stomach, kidneys, liver, ovaries, pancreas, thyroid, meningioma, and multiple myeloma.

To see the trends in obesity-associated cancer deaths over the past two decades, Ahmed and colleagues analyzed CDC data for 33,572 obesity and cancer-related deaths.

They found that the overall age-adjusted mortality rate gradually increased from 3.73 per million in 1999 to 13.52 per million in 2020. “That’s more than a tripling in obesity-related cancer mortality rates over 20 years — a striking rise,” Ahmed told Medscape Medical News.

“To put it in context, this is a steeper increase than seen in many other chronic disease mortality trends during the same time period. It signals a rapidly escalating public health burden,” he noted.

Overall, the average percent change from 2018-2020 was +19.4%. The average annual percentage change was also statistically significant at 5.92 (P < .000001).

In stratified analyses, the overall age-adjusted mortality rate per million was greater in women than in men (7.22 vs 6.59), in non-Hispanic Black persons than in non-Hispanic White persons (9.20 vs 7.13), and in adults aged 65+ than those aged 25-64 (20.82 vs 3.54).

Age-adjusted mortality rates from obesity-associated cancers were also higher in rural than in urban areas (9.45 vs 6.40).

By region, overall, the Midwest had the highest rates and the Northeast had the lowest rates. State-level analysis revealed that Vermont, Minnesota, and Oklahoma had the highest rates, while Utah, Alabama, and Virginia had the lowest.

Underappreciated Link 

The link between obesity and cancer-related mortality is “often underappreciated,” Ahmed told Medscape Medical News.

“Our findings emphasize the need to prioritize obesity screening and management as part of comprehensive cancer prevention. Counseling patients on weight management should be reframed as a critical component of reducing long-term cancer risk,” he said.

Ahmed also noted that socioeconomic factors could be driving the increase in obesity-related cancer deaths.

“While BMI is a contributing factor, disparities in socioeconomic status, access to preventive care, delays in diagnosis, environmental exposures, and cultural factors likely play a larger role in the observed variations across gender and race.”

“For instance, women may face more delayed diagnoses due to under prioritized symptoms, and certain minority groups may encounter systemic barriers to cancer screening and obesity treatment,” Ahmed said.

To tackle the problem of rising rates of obesity-related cancer deaths, Ahmed said policy initiatives should move from downstream management to upstream prevention.

This would include “universal access to cancer screening programs, regardless of income or geography; public health campaigns that normalize obesity management as a cancer prevention strategy; policies promoting equitable access to healthy foods, physical activity, and early intervention services; incentives for primary care to integrate weight management into routine visits; and investment in community-based care models targeting underserved populations,” Ahmed told Medscape Medical News.

This study had no specific funding. Ahmed had no relevant disclosures.