A post from Dr. Arya Sharma
Last week, a series of papers by a pan-Canadian team of cancer researchers, published in Preventive Medicine, looks at the current and future burden of more than 30 different cancer types due to more than 20 different modifiable cancer risk factors.
Not surprisingly, the ComPARe study shows that currently the top five leading preventable causes of cancer in Canada are smoking tobacco, followed by physical inactivity, excess weight, low fruit, and sun – factors that have long been implicated in the development of a wide range of cancers.
According to the researchers, overweight and obesity now rank just behind smoking as a key driver of cancer risk. Obviously, this makes a strong case for increasing efforts at obesity prevention – the caveat being that thus far, no society has yet figured out exactly how this can be effectively achieved at a population level.
While, for obvious reasons, the papers focus on preventative approaches to reduce the burden of cancer, there is little mention of the potential benefits in terms of cancer prevention that could come from offering more effective obesity management to the 8,000,000 Canadians are already living with this chronic disease, who are unlikely to substantially benefit from population strategies to prevent obesity.
Fortunately, there is now a growing body of evidence showing that effective obesity treatment, including bariatric surgery, can substantially reduce cancer risk in people living with obesity. Thus, if anything, these data provide even more reason to get serious about treating obesity (not just hoping that it will somehow disappear if we just keep talking about prevention).
Obviously, even without effective obesity treatments, Canadians living with obesity (like everyone else) will likely benefit from smoking cessation, reducing sedentariness, and increasing their fruit and vegetable consumption (most of them already stay out of the sun). However, effective obesity management aimed at both preventing further weight gain as well as reducing excess body weight (in a sustainable manner) will potentially have even greater benefits in this population.
Unfortunately, as evidenced in the recent 2019 Obesity Canada Report Card on Access to Obesity Treatments, the vast majority of Canadians have little, if any access to obesity treatments within their health care systems – this needs to change if we are to not only reduce the burden of cancers but also of obesity related cardiometabolic disease, arthritis, sleep apnea, and a host of other medical complications.
While we wait for prevention to hopefully one-day kick in, let’s at least get serious about offering effective treatments to the people who already have the problem.