ASCO has called for increased education, research, and advocacy to reduce the toll of obesity, both as a leading cause of cancer and a complication in the care of patients with cancer. The Society’s recommendations outline four critical priorities, including increased education and awareness about links between obesity and cancer, development of new physician tools and resources, intensified and highly coordinated research, and policy changes to increase access to obesity screening, diagnosis, and treatment. The statement was published online in the Journal of Clinical Oncology.1
Policy Statement on Obesity and Cancer a First
In releasing its first-ever policy statement on cancer and obesity, ASCO underscores that obesity is becoming a central challenge in cancer prevention and care, and is projected to soon overtake tobacco as the leading preventable cause of cancer in the United States. By 2030, almost a half million Americans may be diagnosed with obesity-related cancers annually. Among people with cancer, obesity can increase the risk of cancer recurrence and lower survival. In fact, one study suggests that being overweight or obese contributes to as many as one in five cancer-related deaths.2
“With nearly three in four Americans obese or overweight, obesity has become a tremendous public health challenge that also impacts cancer care and prevention today,” said ASCO Immediate Past President Clifford A. Hudis, MD, FACP. “Cancer doctors need to play a lead role in reducing obesity’s impact, both in the care of our patients and as advocates for broader action. We can’t allow obesity to undo decades of progress in prevention, early diagnosis and treatment of cancer.”
Obesity Management in People With Cancer
To ensure that oncologists are better equipped to integrate obesity prevention and management into the care of their patients, and that patients have access to needed services, ASCO’s policy statement calls for:
- Practical guidance and tools for physicians and patients—As the leading organization representing cancer physicians, ASCO is working to provide its members and other oncology providers with weight management guidelines for cancer survivors, tools for initiating conversations about weight loss with patients, and resources to help patients manage their weight. Earlier this year, ASCO issued a guide for oncology providers to support conversations with patients about the effects of obesity on cancer risk and cancer-related mortality, along with a companion guide for patients.
- Increased access to weight management services—The ASCO statement highlights the need to close major gaps in private and public insurance coverage of weight management services, in general, and among people with cancer, in particular. ASCO calls on the Centers for Medicare and Medicaid Services (CMS) to add obesity to the list of chronic diseases eligible for the proposed Complex Chronic Care Management Services payments, and encourages the Department of Health and Human Services to clearly define access to obesity treatment services in the new state health-care exchange plans under the Affordable Care Act.
Prevention of Obesity-Related Cancers
The statement also includes recommendations to help increase awareness of the obesity-cancer connection and advance policies and collaborations needed to prevent obesity-related cancers. These include:
- Increased public education—ASCO aims to partner with other organizations in the cancer community and beyond, fostering greater public awareness about the role of a healthy lifestyle in cancer prevention and building on a wide range of ASCO resources offered for patients with cancer at www.cancer.net/obesity.
- Support for healthy community and workplace environments—ASCO will work with other stakeholders to advance necessary policies at the national level, while calling on oncology care providers to help improve health in their communities by serving as role models and advocates for local change.
- Policies to improve access to obesity screening, diagnosis, and treatment services—ASCO will advocate for improved coverage of recommended treatments for obesity among public and private payers, and for increased availability of services at the community level.
A Robust Research Agenda
While research has documented links between obesity and cancer, many critical areas of research are needed to translate current knowledge into effective treatment and prevention strategies. ASCO’s policy statement calls for the development of a comprehensive, coordinated research agenda to address key questions, including:
- Can weight loss actually reduce the risk of developing or dying from cancer?
- Should obesity be treated differently in cancer survivors, vs people at risk for cancer?
- How and when should weight management interventions be initiated with cancer patients?
Proven Relationship Between Cancer and Obesity
“Research has clearly established that there is a critical relationship between cancer and obesity, but more work is needed to determine whether weight loss, increased physical activity, and improved dietary quality can lower cancer rates and improve outcomes,” said ASCO Energy Balance Working Group Chair Jennifer A. Ligibel, MD, who also serves on ASCO’s Cancer Survivorship and Cancer Prevention Committees. “No single organization or medical specialty can address obesity alone, and we will collaborate with other groups to find evidence-based solutions for our patients.”
ASCO will host a research summit on obesity and cancer later this year, bringing together researchers from multiple disciplines to identify specific research priorities and approaches related to obesity and cancer. ASCO will also continue to advocate for sustained funding to support critical research in this area.
Watch future issues of The ASCO Post for more in depth coverage of the new ASCO Recommendations on Obesity and Cancer. ■
Reference
1. ASCO Policy Statement on Obesity and Cancer: J Clin Oncol. September 1, 2014 (early release online).
