Prevalence, trend and associated factors of obesity-related cancers among U.S. adults with metabolic syndrome: Evidence from the National Health and Nutrition Examination Survey 2001–2018

INTRODUCTION: This study evaluated the prevalence, associated factors and trends in the prevalence of obesity-related cancer (ORC) among U.S. adults with metabolic syndrome (MetS) and age ≥20 years. METHODS: This study used cross-sectional data from the 2001–2018 National Health and Nutrition Examination Survey. The total period analyses included prevalence estimation, chi-square tests for comparing ORC vs non-ORC within subgroups, and a multivariable-logistic regression model to evaluate associated factors of ORC. For trend analysis, the total period was divided into three time periods: 2001–2006, 2007–2012 and 2013–2018. Age-standardized prevalence of ORC in each time period was calculated. RESULTS: The ORC prevalence was 35.8% representing 4463614 adults with MetS. A higher odds of ORC was observed among females (OR = 7.1, 95% CI = 4.9–10.3) vs males, Hispanic (OR = 2.9, 95% CI = 1.7–4.8) and non-Hispanic Black (OR = 2.7, 95% CI = 1.8–4) vs non-Hispanic White, age ≥60 (OR = 5.4, 95% CI = 1.9–15.4) vs age 20–39 years. Individual ORCs were thyroid (10.95%), breast (10%), uterine (9.18%), colorectal (7.86%), ovarian (5.74%), and stomach (0.80%). The age-standardized prevalence of ORC was observed stable in three time periods (30.6%, 30.3% and 30.7%). However, an increasing trend was seen for thyroid, uterine, colorectal and ovarian cancers while decreasing trend for breast cancer. Hispanic people showed a significant increasing trend of ORC (p = 0.004). CONCLUSIONS: ORC was found significantly higher among female, Hispanic, non-Hispanic black and older people with MetS. The stable temporal trend of overall ORC, with an increasing trend in certain ORCs, makes the disease spectrum a public health priority. The findings imply the importance of intensifying efforts to reduce the burden of MetS comorbidities among U.S. adults.