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Obesity paradox in cancer: Is bigger really better?

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journal contribution
posted on 2024-06-18, 15:50 authored by Beata UjvariBeata Ujvari, C Jacqueline, D Misse, V Amar, JC Fitzpatrick, G Jennings, Christa BeckmannChrista Beckmann, S Rome, Peter BiroPeter Biro, R Gatenby, J Brown, L Almeida, F Thomas
While obesity is widely recognized as a risk factor for cancer, survival among patients with cancer is often higher for obese than for lean individuals. Several hypotheses have been proposed to explain this “obesity paradox,” but no consensus has yet emerged. Here, we propose a novel hypothesis to add to this emerging debate which suggests that lean healthy persons present conditions unfavorable to malignant transformation, due to powerful natural defenses, whereby only rare but aggressive neoplasms can emerge and develop. In contrast, obese persons present more favorable conditions for malignant transformation, because of several weight-associated factors and less efficient natural defenses, leading to a larger quantity of neoplasms comprising both nonaggressive and aggressive ones to regularly emerge and progress. If our hypothesis is correct, testing would require the consideration of the raw quantity, not the relative frequency, of aggressive cancers in obese patients compared with lean ones. We also discuss the possibility that in obese persons, nonaggressive malignancies may prevent the subsequent progression of aggressive cancers through negative competitive interactions between tumors.

History

Journal

Evolutionary Applications

Volume

12

Pagination

1092-1095

Location

England

Open access

  • Yes

ISSN

1752-4563

eISSN

1752-4571

Language

English

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2019, The Authors

Issue

6

Publisher

WILEY