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BACKGROUND Annual updates on cancer occurrence and trends in the United States are provided through collaboration between the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). This year’s report highlights the increased cancer risk associated with excess weight (overweight or obesity) and lack of sufficient physical activity (<150 minutes of physical activity per week). METHODS Data on cancer incidence were obtained from the CDC, NCI, and NAACCR; data on cancer deaths were obtained from the CDC’s National Center for Health Statistics. Annual percent changes in incidence and death rates (age-standardized to the 2000 US population) for all cancers combined and for the leading cancers among men and among women were estimated by joinpoint analysis of long-term trends (incidence for 1992–2008 and mortality for 1975–2008) and short-term trends (1999–2008). Information was obtained from national surveys about the proportion of US children, adolescents, and adults who are overweight, obese, insufficiently physically active, or physically inactive. RESULTS Death rates from all cancers combined decreased from 1999 to 2008, continuing a decline that began in the early 1990s, among men and among women in most racial and ethnic groups. Death rates decreased from 1999 to 2008 for most cancer sites, including the 4 most common cancers (lung, colorectum, breast, and prostate). The incidence of prostate and colorectal cancers also decreased from 1999 to 2008. Lung cancer incidence declined from 1999 to 2008 among men and from 2004 to 2008 among women. Breast cancer incidence decreased from 1999 to 2004 but was stable from 2004 to 2008. Incidence increased for several cancers, including pancreas, kidney, and adenocarcinoma of the esophagus, which are associated with excess weight. CONCLUSIONS Although improvements are reported in the US cancer burden, excess weight and lack of sufficient physical activity contribute to the increased incidence of many cancers, adversely affect quality of life for cancer survivors, and may worsen prognosis for several cancers. The current report highlights the importance of efforts to promote healthy weight and sufficient physical activity in reducing the cancer burden in the United States.

A redesigned food insecurity question that measured food stress was included in the 2009 Behavioral Risk Factor Surveillance System in the Social Context optional module. The objective of our study was to examine the association between food stress and obesity using this question as a surrogate for food insecurity. Our analytic sample included 66,553 adults from 12 states. Food insecurity was determined by response (always/usually/sometimes) to the question,"Howoften in the past 12 months would you say you were worried or stressed about having enough money to buy nutritious meals?" T tests were used to compare prevalence differences between groups, and logistic regression was used to examine the association between food insecurity and obesity. Among the 12 states, the prevalence of obesity was 27.1% overall, 25.2% among food secure adults, and 35.1% among food insecure adults. Food insecure adults had 32% increased odds of being obese compared to food secure adults. Compared with food secure adults, food insecure adults had significantly higher prevalence of obesity in the following population subgroups: adults ages ≥30 years, women, non-Hispanic whites, non-Hispanic blacks, adults with some college education or a college degree, a household income of <$25,000 or $50,000 to $74,999, and adults with none or two children in their households. One in three food insecure adults were obese. Food insecurity was associated with obesity in the overall population and most population subgroups. These findings are consistent with previous research and highlight the importance of increasing access to affordable healthy foods for all adults. Both obesity and food insecurity affect health, which is determined not merely by behavioral, biologic, and genetic factors, but also by a range of environmental and social determinants. 8 These include safe environments, adequate income, meaningful and valued social roles, secure housing, higher levels of education, and social support. 8 HHS Public AccessObesity and food insecurity are more prevalent among low-income populations. 5,8 Food insecure adults may rely on low-cost, high-energy foods, 5 which can lead to overconsumption of energy and result in obesity. In 1995 Dietz 9 proposed a relationship between obesity and hunger, the most severe form of food insecurity, based on a case report; since then, a number of studies [10][11][12][13][14][15] have examined the association between obesity and food insecurity among US adults. However, only two studies 16,17 have tested this relationship using data from the Behavioral Risk Factor Surveillance System (BRFSS). The food insecurity question included in BRFSS during the 1990s asked whether the respondent worries about having enough food for herself/himself or her/his family. A study based on this question found that food insecurity was associated with obesity in Washington State during 1995-1999. 16 In addition, Laraia and colleagues 17 analyzed the 1999 BRFSS data for Louisiana and New York and found that, at that time, self-rep...

Sugar sweetened beverage (SSB) consumption may contribute to obesity through excess calorie intake. We examined whether SSB intake during infancy predicts obesity at 6 years. We included 1189 US children who participated in the Infant Feeding Practices Study II in 2005‐2007 and were followed up at 6 years in 2012. Children’s weight and height were measured by mothers. Obesity was defined as BMI‐for‐age and sex 蠅 95th percentile on the CDC growth chart. We used multivariable logistic regression to estimate the associations of SSB consumption in infancy and obesity at 6 years controlling for child’s birth weight, maternal prepregnancy weight status, and maternal and child demographic and dietary characteristics. The obesity prevalence at 6 years among children who consumed SSBs during infancy was twice as high as that among non‐SSB consumers (17.0% vs 8.6%). The adjusted odds of obesity at 6 years was 71% higher for any SSB intake and 92% higher for SSB introduction before 6 months compared with no SSB intake during infancy. Children who consumed SSBs 蠅3 times/week during 10‐12 months had twice the odds of obesity compared with those who consumed no SSBs in this period. However, among children who consumed SSBs, the odds of obesity at 6 years did not differ by age at SSB introduction during infancy or mean weekly SSB intake during 10‐12 months. Our study findings suggest that SSB consumption during infancy may be a risk factor for obesity in early childhood. Whether unmeasured behaviors contributed to the association is unclear.

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Sugar‐sweetened beverage (SSB) intake is associated with adverse health consequences including obesity and dental caries. Due to limited information on associations between SSB intake during infancy and intake of SSBs in childhood, we examined this question using longitudinal data for 1333 U.S. children from the 2005‐2007 Infant Feeding Practices Study II and the 2012 Follow‐up Study at 6 years of age. Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) for associations of SSB intake during infancy with consuming SSBs 蠅1 time/day at 6 years old after controlling for baseline characteristics. Based on maternal report, one‐fifth of children consumed SSBs at least 1 time/day at 6 years. The adjusted odds of consuming SSBs at 6 years 蠅1 time/day was significantly (p<0.05) higher among infants with any SSB intake during infancy vs. none (aOR=2.22), SSB introduction at <6 months (aOR=2.01) or 蠅6 months (aOR=2.33) vs. never, and mean SSB intake between 10 and 12 months of age (aOR=2.72 for 1‐<2 times/week, and 2.57 for 蠅3 times/week, vs. none). SSB intake during infancy significantly increased the likelihood of consuming SSBs 蠅1 time/day at 6 years of age. Our findings suggest that infancy may be an important time for mothers to establish healthy beverage practices for their children and these findings can be used to inform intervention efforts to reduce SSB intake among children.