Global trends in adenocarcinomas and obesity: an epidemiologic link?

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Abstract
Sirs—Recent studies on cancers of lung,1 oesophagus,2 gastric cardia,3 kidney,4 prostate,5 breast,6 colon,7 gall bladder,8 uterine cervix,9 and endometrium10 show an increasing trend in a particular histological sub-type, namely, adenocarcinoma, especially among the relatively young cohorts. The biological implication of this distinct epidemiological and potentially aetiological entity is poorly understood. Long-term trends in cancer incidence do provide significant leads to an underlying causal pathway. However, trends of major cancer sites by histological sub-types have received little attention. Such trends may identify the possible role of any putative risk factors, which may not be apparent in studies looking at the overall cancer trends. For instance, despite a downturn in overall lung cancer incidence, younger females are experiencing a relatively steep increase in lung adenocarcinoma incidence, while the remaining histological sub-types of lung cancer have stabilized in both sexes across the globe, possibly suggesting a different biological mechanism.