Cancer and Body Composition: An Association of Global Relevance

Context: Worldwide, cancer is the second leading cause of death, with a rapidly increasing global incidence: it is present in high and in lower-middle income countries (LMICs). Overweight and obesity are also a major global health concern, and while they were once considered conditions specific to the ‘Western’ world, this geographic patterning has begun to shift. Evidence Acquisition: Given the large body of evidence regarding associations between lower socioeconomic status and greater cancer incidence and mortality, we undertook a narrative review focusing on global cancer burden and risk, and the association between cancer and body composition, particularly in LMICs. Using the MeSH terms ‘cancer’ and ‘body composition’, and keywords ‘overweight’ or ‘obesity’, and the phrase ‘lower-and middle-income countries’, we identified relevant articles for inclusion in this narrative review. Results: The key diagnostic mechanism underpinning these associations may be the varied prevalence and distribution of the risk factors most commonly associated to cancer incidence, including smoking, alcohol and diet. Approximately one-third of cancerrelated deaths in high income countries (HICs) are due to dietary and behavioural risk factors, which includes overweight and obesity and physical inactivity, and these same risk factors are prevalent in LMICs, which is where the current, yet minimal, priorities for cancer prevention are aimed at reducing. Conclusions: These data have specific relevance to LMICs in context of increasing levels of obesity, fewer healthcare resources in many LMICs, and lower financial investment into the prevention and management of cancer. Recognising and understanding the process by which cancer risk is linked to body composition parameters and obesity-related lifestyle factors will inform future intervention and prevention efforts. The focus needs to be directed towards implementing