ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: Lancet Diabetes Endocrinol 2018; 6(2):95-104

As non-communicable diseases (NCDs) are reaching epidemic levels, emerging data elucidate the devastating non-metabolic long-term risks of overweight, obesity and diabetes. Using published relative risk analysis and cancer incidence estimates from the GLOBOCAN project, the authors provide a thorough risk analysis of site-specific cancers including colorectal, gallbladder, pancreatic, liver, breast, and endometrial cancer attributable to high BMI, diabetes, and the combination of the two. Their estimate that 6% of new cancers are due to the combined effect of high BMI and diabetes is substantial and, more concerningly, is projected to increase by 20-30% over the next 10 years. Interestingly, the attributable cases in women are almost double that of men and account for the majority of the projected increase. There was significant regional variability with regards to cancer specific proportions of total cancer burden as well as PAF of cancer attributable to high BMI, diabetes or both, possibly explained by variations in risk factor prevalence. PAFs in low-and middle-income regions were lower than in most high-income regions, although in the absence of disease registries and reliable ascertainment, both diabetes and cancer epidemiologic data from many low- and middle-income countries should be interpreted with caution. However, even when data inaccuracy is taken into account, it is alarming that the proportion of cancer cases attributable to the increase in prevalence of high BMI and obesity was largest in low- and middle-income countries across sub-Saharan Africa and Asia. Most likely, this reflects the rapidly increasing rates of obesity, diabetes and non-communicable diseases in these regions. Immediate preventive public health measures and care delivery efforts need to be identified and put in place to curb this epidemic and its foreseeable short- and long-term detrimental health consequences.