Updated: February 2023

Author: Cancer Program, Vermont Department of Health

Cancer is a group of more than 100 different disease that often develop gradually and as the result of a complex mix of lifestyle, environmental and genetic factors. Obesity is one of many factors that can increase the risk of developing certain types of cancer, as well as type 2 diabetes, hypertension, heart disease, stroke, and osteoarthritis. Obesity is often measured using a screening tool called the “body mass index” (BMI). The CDC defines a BMI greater than 30 to be obese. A BMI greater than 30 is not a diagnosis of obesity, rather a method for health care providers assesses potential health risks. Lack of physical activity and nutrition are the main contributors to obesity. Approximately 30% of the cancers diagnosed in the U.S. are linked to these risk factors. Excess weight is linked to an increased risk of developing the following cancers: breast (postmenopausal), colon and rectum, uterus, thyroid, pancreas, kidney, esophagus, gallbladder, ovary, cervix, liver, non-Hodgkin lymphoma, myeloma, and prostate (advanced stage).

In addition to being associated with higher rates of cancer, excess weight has also been associated with poor prognosis among cancer patients and survivors. Outcomes include complications from treatments, increased recurrence of cancers, and increased mortality. Excess body weight, poor nutrition, and physical inactivity may contribute to as much as one-third of cancer deaths in the U.S. Vermonters today are more likely to die from a largely preventable disease than an infectious disease. The Health Department’s 3-4-50 initiative is a simple framework to help us grasp the reality of the impact of obesity on chronic disease. The initiative promotes the concept that 3 health behaviors (lack of physical activity, poor diet, and tobacco use) contribute to 4 chronic diseases (cancer, cardiovascular disease, lung disease and diabetes) that claim the lives of more than 50 percent of Vermonters.

Cancer is the state's leading cause of death. Each year, over 3,400 Vermonters are diagnosed with cancer, and more than 1,200 Vermonters die from the disease. Approximately one-third of all cancer deaths in the United States are linked to excess body weight, poor nutrition, and physical inactivity. This measure will help to gauge the success in decreasing the impact of overweight and obesity in Vermont.

Vermont Department of Health Comprehensive Cancer Control Program

Vermont Department of Health Physical Activity and Nutrition Program

Vermont Cancer Registry

Vermonters Taking Action Against Cancer (VTAAC)

The rate of obesity and obesity-associated cancers can be reduced through a comprehensive approach to increase physical activity and improve nutrition among Vermont youth and adults. Several evidence-based strategies have been identified that improve obesity prevalence, including:

• Providing supermarkets and farmers' markets with incentives to establish their businesses in low-income areas and to offer healthy foods.
• Supporting programs that bring local fruits and vegetables to schools, businesses, and communities.
• Encouraging the provision of quality physical education in schools and childcare facilities.
• Supporting worksite wellness initiatives that help adults lead healthy lives.
• Promoting healthy community design that supports active living and healthy eating, making it easier for people to live healthy lives.
• Primary care and other providers being trained in motivational interviewing and other patient-centered approaches to engage with patients about their weight and lifestyle choices.

The Vermont Cancer Plan, published by the Vermont Department of Health Comprehensive Cancer Control Program (VT CCC) and the statewide cancer coalition Vermonters Taking Action Against Cancer (VTAAC), provides a strategic roadmap for reducing the burden of cancer in Vermont. The Comprehensive Cancer Control Program, the Physical Activity and Nutrition Program and VTAAC partners work to coordinate evidence-based priority activities based on the State Cancer Plan to reduce obesity among Vermonters. Priority strategies currently underway include:

• Supporting Vermont schools in developing and implementing local wellness policies.
• Supporting worksites in developing policies and programs to promote healthy behaviors.
• Supporting healthy community design initiatives, such as increasing opportunities for physical activity and access to healthy foods, to make it easier for people to live healthy lives.
• Promoting messages to health care providers and the public emphasizing the link between obesity and cancer.

In December 2017, the methodology for computing risk factor-associated cancers changed to be consistent with CDC methodology, updated October 2017. The CDC documentation defines cancers associated with certain risk factors, including tobacco, HPV, and obesity. Rates for risk factor-associated cancers published prior to December 2017 should not be compared to rates for risk factor-associated cancers published December 2017 or later. In addition, rates published later than May 2018 should not be compared to rates for risk factor-associated cancers published earlier due to additional methodological changes (excluding non-microscopically confirmed cases). Differences between rates in older versus current publications are likely due to methodological changes rather than changes in the rates or underlying risks for developing risk factor-associated cancers. 

All rates are age adjusted to the 2000 U.S. standard population and exclude basal cell and squamous cell skin cancers. Incidence rates exclude in situ carcinomas except urinary bladder. Incidence data were coded using the International Classification of Disease for Oncology (ICD-O) coding system. Vermont cases include Vermont residents only. Data Source: Vermont Cancer Registry, Vermont Department of Health (1994-2013). A reporting delay by Department of Veterans Affairs (VA) has resulted in incomplete reporting of VA hospital cases in 2011, 2012, and 2013.