Review of Obesity and Cancer
To the Editor Dr Shen and colleagues provided a timely and useful Review of the biological links between obesity and cancer. They appropriately identified hepatobiliary cancer as one of the malignancies most strongly associated with excess adiposity and include liver cancer among obesity-related cancers. Yet liver cancer may be harder to accommodate within a broad pan-cancer framework because the…
Dr Shen and colleagues have delivered a valuable review on the biological connections between obesity and cancer. They accurately highlighted hepatobiliary cancer as one of the cancers most strongly linked to excessive body fat and consider liver cancer as part of obesity-related cancers. However, liver cancer may pose a challenge when viewed under a broad cancer umbrella, as the transition from obesity to hepatocarcinogenesis is often driven more by chronic liver damage than simply body weight.
In the liver, increased fat accumulation typically coincides with inflammation, fibrosis, and structural changes, all of which contribute to the development of liver cancer. Thus, the liver is not merely another organ affected by systemic inflammation, hormonal imbalance, oxidative stress, impaired immune response, and altered microbiome; it is an organ where metabolic injury acts as the direct carcinogenic environment.
Therefore, individuals with the same Body Mass Index (BMI) can still exhibit vastly different risks for liver cancer, and some people with a lower BMI but significant metabolic issues or liver scarring may face a higher risk than those with a higher BMI but less liver disease.
Written by urgent.news from JAMA's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
