Preventing the rise in obesity-related cancers in Asia

The global prevalence of obesity has more than doubled since 1990 and it is no longer seen as a disease of only high-income countries (WHO Fact Sheet). In 2022, around 43% of the world’s adults were overweight and almost 1 billion were obese, with a dramatic rise also observed in children.

Whether overweight or obese, elevated body mass index in adults is associated with an increased risk of cancer. Some of the highest global rates of obesity and obesity-attributable cancers are in the Asia-Pacific region. Up to 6% of cancer cases were estimated to be attributable to excess bodyweight in 2012 in Oceania – particularly in the Pacific Islands (International Agency for Research on Cancer) – and this may be a considerable underestimation given recent obesity trends and limited reporting systems. Many different cancer types are linked to overweight/obesity, and breast cancer in post-menopausal women is just one example, with up to 19% of cases in the Asia and Oceania regions attributable to excess bodyweight in 2012 (International Agency for Research on Cancer). In some countries in Asia (e.g. Mongolia, Malaysia and Thailand), around one-third of some gynaecological cancers are attributable to excess bodyweight, with proportions as high as 40–60% in Oceania (e.g. Samoa, Fiji, Solomon Islands, Australia and New Zealand). While screening for cancers like breast and cervical may be particularly beneficial in those who are already overweight or obese, it may not be economically viable: the programme and the availability of diagnostics are expensive and, if cancer is detected, not every country has the resources to treat it appropriately.

Tackling the growth in obesity is critical to achieving the Sustainable Development Goal target of reducing premature mortality from non-communicable diseases by one-third by 2030. It is clear that affordable health sector responses designed and equipped to identify the risk of overweight/obesity and to prevent, treat and manage it are urgently needed. A crucial part of this is to support at-risk individuals to adopt healthier behaviours and to find ways to navigate the barriers to this. Dietary and physical activity patterns are often not only due to personal choice but are also largely the result of environmental and societal conditions. A healthy diet may not be affordable and there may not be time or space for physical activity. In addition, obesity is a culturally sensitive issue in some countries. How body size is perceived varies and therefore obesity prevention must be approached delicately.

At the 75th World Health Assembly in 2022, member states demanded and adopted new recommendations for the prevention and management of obesity and endorsed the World Health Organization Acceleration Plan to Stop Obesity. As set out in the plan, multisectoral policies and actions are needed that go beyond the health sector and are implemented through a co-ordinated whole-of-society approach. This includes creating environments that make regular physical activity and healthier food options available, accessible and desirable from an early age. Based on the plan, countries can set their own priorities and develop their own acceleration roadmaps, selecting interventions that best align with their needs, resources, budget and culture.