Journal
ANNUAL REVIEW OF MEDICINE
Volume 61, Issue -, Pages 301-316Publisher
ANNUAL REVIEWS
DOI: 10.1146/annurev.med.080708.082713
Keywords
insulin resistance; insulin-like growth factors; sex steroids; adipokines; hypoxia; genome-wide association
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Funding
- Christie NHS Foundation Trust
- Cancer Research UK
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Body mass index, as an approximation of body adiposity, is associated with increased risk of several common and less common malignancies in a sex- and site-specific manner. These findings implicate sex- and cancer site-specific biological mechanisms underpinning these associations, and it is unlikely that there is a one system fits all mechanism. Three main candidate systems have been proposed-insulin and the insulin-like growth factor-I axis, sex steroids, and adipokines-but there are shortfalls to these hypotheses. In this review, three novel candidate mechanisms are proposed: obesity-induced hypoxia, shared genetic susceptibility, and migrating adipose stromal cells. While public health policies aimed at curbing the underlying causes of the obesity epidemic are being implemented, there is a parallel need to better understand the biological processes linking obesity and cancer as a prerequisite to the development of new approaches to prevention and treatment.
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