IfPA’s Health Policy Blog explores health policy news, reports, initiatives and events through the lens of a single question: What is the impact on patient access?

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Obesity Threatens to Roll Back Progress Against Cancer

America faces a good news-bad news situation, according to the newly published annual report from the American Cancer Society.

The country saw the largest ever one-year decline in the overall cancer death rate for men, women and communities of color. The most recent data, from 2016-2017, show the death rate declined by 2.2%. The decrease is due, in large part, to improved lung cancer treatment and a continuous decline in smoking.

While smoking is trending down, however, obesity is surging. And that trend could have serious implications for cancer.

Replacing Tobacco with Obesity

A staggering 42% of adults in America are now obese. This raises a red flag for cancer researchers since obesity has a well known, but seldom discussed, link to multiple cancers. In fact, some experts warn that obesity could soon overtake smoking as the nation’s main driver of new cancer cases. Many obese people have chronic low-level inflammation, for example, which can cause DNA damage that leads to cancer.

The report also notes that progress against breast and colon cancers has slowed. This trend is likely influenced by the rising tide of obesity, according to Farhad Islami, MD, PhD, who leads the American Cancer Society’s cancer disparity research team.

Being obese can lead to insulin resistance, which precedes the development of diabetes and may promote the development of colon, kidney and some other cancers. Fat tissue also produces excess amounts of estrogen, which at high levels, has been associated with increased risk of several cancers, including breast and ovarian.

A Renewed Effort to Overcome Obesity

Obesity’s role as a cancer driver could raise the stakes in the nation’s fight against obesity. Eating a healthy diet and exercising regularly are important, nevertheless, they are difficult habits for many Americans to adopt long term. And obese people who successfully shed pounds on their own may be prone to relapse weight gain because of physiological changes in the body.

Treatment can play a role, and a new medication, semaglutide, broadens the range of options. Semaglutide has been described as “game changing” for its ability to help patients achieve average weight losses of 15-20%, when combined with diet changes and regular exercise, in clinical trials. Despite its early success, limited coverage and insurance barriers may make it hard for patients to access.

As with the battle against cancer, the battle against obesity rages on, fueled by more knowledge, new treatment approaches and cutting-edge medications. Perhaps both fronts will get a boost since it’s now clearer than ever that these two battles are closely linked.

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