Growing burden of cancer and high body mass index in the United States from 1990-2021: A benchmarking cross-state analysis.

10528 Background: Cancer (CA) remains a major public health challenge and is the second leading cause of death and disability in the United States. Among the various modifiable risk factors, a high body mass index (h-BMI) significantly contributes to the burden of non-communicable diseases, including CA. Methods: This study is the first to estimate deaths and disability attributable to h-BMI for 12 different CA types across the USA, disaggregated by age, sex, year, and location, using the standardized Global Burden of Disease Study 2021 methodology from 1990–2021. Results: From 1990-2021, the annual percentage change (APC) in age-standardized mortality rates (ASMR) due to CA attributable to h-BMI increased by 0.22%, disability-adjusted life years rates (ASDALR) by 0.19%, and years lived with disability rates (ASYLDR) by 0.78%. Among all CA, the highest increase in APC for ASMR was observed for liver CA at 3.81%, followed by pancreatic CA at 2.66%, uterine CA at 1.16%, thyroid CA at 0.84%, multiple myeloma at 0.50%, and kidney CA at 0.35%. Conversely, APC decreased for leukemia by 0.16%, ovarian CA by 0.37%, non-Hodgkin lymphoma by 0.44%, and gall bladder and biliary tract CA by 0.45%, as well as for colon and rectum CA by 0.49%, and breast CA by 0.85%. Among states, Mississippi observed the highest increase in APC for ASMR at 1.21%, followed by Oklahoma at 1.39%, West Virginia at 1.20%, and New Mexico at 1.19%. In terms of ASYLDR, the largest increases were seen in New Mexico at 1.83%, California at 1.77%, Mississippi at 1.74%, West Virginia at 1.60%, and Tennessee at 1.47%. Age-wise, individuals aged 20-54 recorded 3,833 deaths (95% uncertainty interval: 1,727-5,876), while those 55 and older recorded 43,371 deaths (16,854-71,488) in 2021. Similarly, DALYs for ages 20-54 were 173,448 (82,011-258,288), and for those 55 and older were 930,410 (366,885-1,528,824). In terms of gender, males observed higher increases in ASMR and ASDALR compared to females, with 0.58% vs 0.06% and 0.46% vs 0.05%, respectively, while females saw higher increases in ASYLDR at 1.02% compared to 0.86% from 1990-2021. Conclusions: Deaths due to CA attributable to h-BMI accounted for 14.95% of all CA attributable risk factors in 2021. Notably, liver, pancreatic, and uterine CA have shown the most significant rises in ASMR, highlighting an urgent need for targeted public health strategies and research to address these alarming trends. Conversely, decreases in APC for CA like leukemia, ovarian, and breast CA suggest that some progress is being made, possibly attributed to advancements in treatments and early detection programs. Age and gender analyses further illuminate the disproportionate burden of CA on older adults and males, though females exhibit a higher increase in YLDs.