Obesity-related cancer mortality increased significantly during the past two decades in the United States, according to study data presented at ENDO 2025, the annual meeting of the Endocrine Society. The research showed that cancer deaths related to obesity have essentially tripled from 1999 to 2020, with significant disparities seen by gender, race, age, and geography.
The highest cancer mortality rates were observed among older adults, rural populations, and people living in the Midwest. Women and certain minority groups were also disproportionately affected.
“Obesity is a significant risk factor for multiple cancers, contributing to significant mortality,” said Faizan Ahmed, MD, the study’s lead author and internal medicine resident at Hackensack Meridian Jersey Shore University Medical Center. “This research underscores the need for targeted public health strategies such as early screening and improved access to care, especially in high-risk rural and underserved areas.”
Obesity has long been associated as a cardiovascular or metabolic risk factor, but it is also as a significant oncologic concern. The body mass index (BMI), which is used as a screening tool for overweight and obesity, defines overweight as having a BMI from 25.0 to 29.9 and obesity with a BMI that is 30.0 or higher. The Centers for Disease Control and Prevention (CDC) have identified 13 types of cancer that are associated with obesity: esophageal adenocarcinoma, postmenopausal breast cancer, colorectal cancer, uterine cancer, gallbladder cancer, upper stomach cancer, kidney cancer, liver cancer, ovarian cancer, pancreatic cancer, thyroid cancer, meningioma, and multiple myeloma. These cancer types comprise 40% of all malignancies that are diagnosed every year in the United States.
In this study, Dr. Ahmed and colleagues examined trends in cancer-related mortality, using the CDC WONDER database to analyze 33,572 deaths from obesity-associated cancers between 1999 and 2020. They calculated age-adjusted mortality rates per million to identify trends and high-risk populations for targeted public health interventions.
Overall, they found that the overall age-adjusted mortality rate gradually rose from 3.73 per million in 1999 to 13.52 per million in 2020, which was more than a three-fold increase in cancer mortality rates during the 20-year period. Nearly half of these obesity-associated cancer deaths occurred in medical facilities (47.7%).
The average annual percent change (APC) in mortality was 5.92% overall (P < .00001), but sharp increases occurred between 2018 and 2020, with an APC of 19.37% (P < .00001).
When stratified by race/ethnicity, overall age-adjusted mortality rate per million was greater in non-Hispanic Blacks versus non-Hispanic Whites (9.20 vs 7.13). Hispanics had the highest average APC of 6.31% (P < .001) while Blacks had the lowest (5.37%; P < .00001).
Analysis by gender showed that the age-adjusted mortality rate was 7.22 for women versus 6.59 for men, and with an average APC of 5.37% (P < .0001) versus 6.75% (P < .00001), respectively.
When looking at age, individuals 65 years and older had a significantly higher mortality rate (20.82) as compared to younger adults. This rate peaked at 41.54 in 2020, with an average APC of 6.26% (P < .00001).
Finally, the researchers also looked at how geography played a role in obesity-related cancer mortality. The Midwest had the highest rate (7.96) with an average APC of 6.01% (P < .00001), while the Northeast was lowest at 5.7 with an APC of 5.56% (P < .00001). When broken down by individual states, mortality rates were above the 90th percentile for Vermont, Minnesota, and Oklahoma but below the 10th percentile for Utah, Alabama, and Virginia. Both rural and urban areas had increased mortality rates (6.03% vs 6.98%).
The authors note that given these trends, targeted public health campaigns that include preventive measures, early screening, and equitable healthcare access, are pivotal.
Obesity-Associated Cancer Mortality in the United States (1999-2020): A National Epidemiological Analysis. Abstract SUN-583. Presented July 13, 2025. ENDO 2025, the annual meeting of The Endocrine Society
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