Waist Circumference is a Stronger Predictor of Obesity-Related Cancer Risk Than BMI in Men

A new study from Lund University, Sweden, reveals that waist circumference (WC) is a stronger predictor of obesity-related cancer risk in men compared to body mass index (BMI), while in women, both metrics are equally effective.

The findings will be presented at the European Congress on Obesity (ECO 2025) in Malaga, Spain, from May 11–14, 2025, and published in The Journal of the National Cancer Institute.

Key Findings of the Study

Researchers analyzed health data from 339,190 individuals over an average follow-up of 14 years, during which 18,185 obesity-related cancer cases were recorded. The study found:

• In men, an 11 cm (4-inch) increase in waist circumference was linked to a 25% higher risk of developing obesity-related cancers, while a comparable BMI increase (3.7 kg/m²) raised the risk by 19%.

• In women, both a 12 cm wider waistline and a BMI increase of 4.3 kg/m² were associated with a 13% higher cancer risk.

• Abdominal fat, particularly visceral fat (a type of body fat that surrounds internal organs like the liver, pancreas, and intestines), is metabolically active and contributes to insulin resistance, inflammation, and abnormal blood fat levels, which increase cancer risk.

• Men store more visceral fat, making waist circumference a more accurate predictor of cancer risk, whereas women tend to store fat more evenly across the body, reducing waist circumference’s predictive strength.

• Including hip circumference in risk models may improve cancer risk assessments, especially for women.

Why Waist Circumference is a Better Cancer Risk Indicator

Unlike BMI, which measures body size but does not account for fat distribution. Waist circumference directly correlates with abdominal adiposity. Abdominal adiposity is the accumulation of excess fat in the abdominal region specifically around the stomach and waist. This fat can be subcutaneous fat (stored just under the skin) or visceral fat (which surrounds internal organs like the liver and intestines).

Visceral fat (a type of body fat that surrounds internal organs like the liver, pancreas, and intestines), has been linked to an increased risk of obesity-related cancers, including esophageal, gastric, colorectal, liver, pancreatic, breast (postmenopausal), ovarian, and thyroid cancers, among others.

Public Health Implications

The findings of this study align with some of the recommendations that are pushed by experts. 

For example, England's NHS recommendations also advocate for waist circumference and BMI checks as part of annual health assessments for 15 million individuals with long-term conditions.

Experts also suggest using additional metrics like waist-to-height and waist-to-hip ratios to enhance obesity-related health risk evaluations.

Conclusion

This study highlights the importance of waist circumference as a key health indicator, particularly for men. Researchers emphasize the need for further studies on sex-specific fat distribution and cancer risks to develop more precise health assessment tools.

For those looking to assess their cancer risk, tracking waist circumference along with BMI and other body fat indicators can provide a more comprehensive health evaluation and early intervention opportunities.

Sources:

European Association for the Study of Obesity (2025). Waist circumference outshines BMI as obesity-related cancer risk marker in men, but not women. Retrieved from: https://medicalxpress.com

Recalde, M., Davila-Batista, V., Díaz, Y. et al. Body mass index and waist circumference in relation to the risk of 26 types of cancer: a prospective cohort study of 3.5 million adults in Spain. BMC Med 19, 10 (2021). https://doi.org/10.1186/s12916-020-01877-3