Obesity and cancer – time for concerted action

Over the last twenty years, there’s been a steady increase in rates of obesity in the UK. Around two-thirds of adults in the UK are now overweight or obese.

This places them at increased risk of a range of health problems – including up to ten different types of cancer.

But despite this dramatic increase in the nation’s waistline, and the growing impact on its health, progress in tackling obesity has been slow. The recently published cancer strategy for England pointed out that:

There has, to date, not been co-ordinated and concerted action taken to address obesity, and it is essential that this now becomes a priority

Today we’ve published a new report – Tipping the Scales – to try to galvanise action on obesity, and to show that without it, the epidemic will only get worse – leading to hundreds of thousands of people falling ill, and costing the NHS billions.

Modelling the future

The UK has changed a lot since the 1990s – the decade of John Major, Take That, Sega Megadrives and Baywatch. But in the 25 years since, the nation’s excess bodyweight has led to tens of thousands of cases of cancer that could have been avoided.

And regardless of whatever cultural fads we see over the next 20 years, we want to ensure that we don’t see a similar failure to protect people from obesity-related cancers over the next 25 years.

But to make the case for political action, we need to understand the potential future impact of obesity on cancer and the NHS. And to do so, we teamed up with the UK Health Forum – the team behind the last major Government report on obesity trends  – the Government Office for Science’s  2007 ‘Foresight’ report (which we blogged about at the time).

For the new report, we analysed a range of data on weight and lifestyle behaviours across the UK, together with information on changes in the population, and then used mathematical models to uncover the likely impact obesity will have on:

• The proportion of people who will be overweight or obese by 2035 if current trends continue.
• The number of cases of different diseases (cancer, diabetes, coronary heart disease and stroke) which could be avoided by reducing levels of obesity, both over the next 20 years and annually from 2035.
• The ‘direct’ cost of obesity to the NHS and health care (calculated from primary and secondary care, urgent and emergency (A&E) care, community care, prevention and health promotion and social care) and the ‘indirect’ cost to society from lost economic productivity due to early illness and death.

What we found

Our headline findings are a real cause for concern. If current trends continue, we predict that:

1) The UK will get heavier

The proportion of people who will be obese looks set to continue increasing: by 2035 around four out of ten who will be obese:

The poorest in our society will continue to be most affected, with almost half (49 per cent) of women from the poorest fifth of the UK projected to be obese in 2035, compared to a quarter (25 per cent) of women from the richest fifth. This trend, though less pronounced, is the same for men.

2) This will lead to millions of new cases of disease

Over the next 20 years, we’ve estimated that rising levels of obesity could lead to around 700,000 new cases of cancer – a staggering number.

This means that, by 2035, the UK’s weight problem could be causing around 38,500 extra cases of cancer a year. This estimate is higher than previous research we’ve funded, and emphasises the significant burden of obesity as a risk factor for cancer.

But on top of this, we also found that as well as cancer, obesity could also cause millions more cases of diseases like type 2 diabetes, heart disease and stroke – all of which cast a worrying shadow over the nation’s health prospects.

3) As well as hitting the country’s waistlines, it’ll also hit the purse-strings

We estimate that by 2035, these diseases could be costing the NHS and social care services an additional £2.5bn per year, every year, which we predict to be a conservative estimate. The striking thing is that while obesity-related cancers are relatively small proportion of the total, the cost of treating them is high – £330m a year.

This adds weight to previous predictions about the eye-watering cost of obesity to society. For example, the Foresight report projected that overweight and obesity would cost the NHS a total of £8.3bn per year from 2030. But they all show a clear message – if the Government doesn’t act now, avoidable obesity-linked diseases will cost the NHS billions of pounds every year.

4) There’s hope – small reductions can have a substantial impact

As well as obesity’s impact, we also looked at what small reductions in obesity rates could do to mitigate it.

Reducing the prevalence by just one per cent each year below the predicted trends could avoid 64,200 new cases of cancer over the next 20 years.

In the year 2035 alone, this would likely save £300 million in NHS health and social care costs for all diseases caused by obesity, of which £42 million could be saved through NHS cancer care.

What can be done?

While these are just a brief summary of the report’s findings, they emphasise its central point – that the Government must act to help avoid obesity-linked cancers.

We want the Government to develop policies that could help achieve consistent reductions in obesity – we’ve discussed a range of recommendations in the report.  Many of these focus on preventing children from gaining weight, because there’s substantial evidence that the obesity problem starts early: obese children are much more likely to become obese adults. And in the UK, one-fifth of children are obese before their eleventh birthday.

Options the government could consider include:

• A ban on TV advertising of junk food between 6am and 9pm (something we discuss at length here)

• Restrictions on online marketing of unhealthy food and drinks

• A 20p/litre tax on sugary drinks

• Looking into new or higher taxes on foods high in sugar, salt and fat, while making and healthy alternatives cheaper

• Making healthier food more widely available in publicly-funded institutions such as schools and hospitals

• Better food labelling (more on this here)

• Wider availability of recreation facilities and open space, particularly for lower-income groups

• Better promotion of walking and cycling as easy and accessible modes of transport

• Putting more pressure on food producers to reduce free sugars, saturated fat and calories in their products

Happily, the Government has made welcome signs that it intends to get serious, and to try to reduce the number of children who are obese. Next month, it’s due to publish a new children’s obesity strategy – something we’re eagerly awaiting, and in which we hope to see practical policies to achieve consistent reductions in obesity.

2035 may seem a long time away. By then, there will have been ten Olympic Games, several UK Prime Ministers, and countless pop-culture fads. But in order to prevent the current obesity epidemic from wreaking havoc with the nation’s health, we need action – and we need it now.

• Dan Hunt is a Policy Advisor at Cancer Research UK

Download a copy of our report – Tipping the Scales – or read an executive summary.