![]() This finding highlights that BMI underestimates the real prevalence of overweight and obesity, since it only considers weight and height of the patients and not total body fat, which really defines the obesity-associated comorbidity risk. Despite body mass index (BMI) being used for a long time as the best way to diagnose and define obesity, recent studies have proposed that BMI misclassified subjects with increased cardiovascular risk factors ( 2). Obesity has reached epidemic proportions constituting one of the most important diseases of this century ( 1). Since obesity and cancer present a high prevalence, the association between these conditions is of great public health significance and studies showing mechanisms by which obesity lead to cancer development and progression are needed to improve prevention and management of these diseases. In this review, three main pathways relating obesity and cancer development are examined: (i) inflammatory changes leading to macrophage polarization and altered adipokine profile (ii) insulin resistance development and (iii) adipose tissue hypoxia. In this sense, obesity may lead to cancer development through dysfunctional adipose tissue and altered signaling pathways. Tumor growth is regulated by interactions between tumor cells and their tissue microenvironment. Furthermore, it has been estimated that 15–20% of all cancer deaths may be attributable to obesity. Cancer is the first death cause in developed countries and the second one in developing countries, with high incidence rates around the world. ![]() Association between obesity and cancer has also been well established for several tumor types, such as breast cancer in post-menopausal women, colorectal, and prostate cancer. ![]() Obesity constitutes one of the most important metabolic diseases being associated to insulin resistance development and increased cardiovascular risk.
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