Obesity-related cancer deaths have tripled in the United States over the past 2 decades, with significant disparities seen by gender, race, age, and geography, according to findings from a national epidemiological analysis presented at ENDO 2025, the annual meeting of The Endocrine Society (Abstract SUN-583).
The highest cancer mortality rates were seen among older adults, rural populations, and those from the Midwest. Women and racial minorities were also disproportionately affected.
“Obesity is a significant risk factor for multiple cancers, contributing to significant mortality,” stated lead researcher Faizan Ahmed, MD, of Hackensack Meridian Jersey Shore University Medical Center in Neptune City, New Jersey. “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.”
Study Methods and Rationale
The Centers for Disease Control and Prevention (CDC) have identified 13 types of cancer that are associated with obesity, including: 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.
The researchers analyzed mortality data from the CDC WONDER database for 33,572 obesity-associated cancer deaths between 1999 and 2020, and calculated age-adjusted mortality rates per million to identify trends and high-risk populations.
Key Study Findings
In 1999, the age-adjusted mortality rate was 3.73 (95% confidence interval [CI] = 3.45–4.01); it increased to 13.52 (95% CI = 13.08–13.97) in 2020. The majority of these obesity-associated cancer deaths occurred in medical facilities (47.7%).
The average annual percent change was 5.92% overall (95% CI = 5.23%–6.44%; P < .00001), but sharp increases were observed between 2018 and 2020, showing an average annual percent change of 19.37% (95% CI = 9.59%–24.20%; P < .00001).
When analyzing the data by gender, the age-adjusted mortality rate was 7.22 for women, with an average annual percent change of 5.37% (P < .0001), compared with a mortality rate of 6.59 and an annual percent change of 6.75% for men (P < .00001).
When analyzing by race, Hispanic individuals showed the highest average annual percent change of 6.31% (P < .001) and Black individuals had the lowest percent change of 5.37% (P < .00001).
By age, those 65 years and older showed a mortality rate of 20.82, which was much higher than the 25 to 64 group. For those 65 years and up, the mortality rate was highest at 41.54 in 2020 with an average annual percent change of 6.26% (P < .00001).
According to geography, the Midwest had the highest mortality rate of 7.96 with an average annual percent change of 6.01% (P < .00001) compared with the lowest mortality rate of 5.7 for the Northeast, which had an annual percent change of 5.56% (P < .00001). By state, mortality rates were above the 90th percentile for Vermont, Minnesota, and Oklahoma compared with rates below the 10th percentile for Utah, Alabama, and Virginia. Increased mortality rates affected both rural and urban areas with average percent changes of 6% to 7%.
Disclosure: For full disclosures of the study authors, visit endocrine.org.
