Obesity-related cancers surge, straining Puerto Rico’s care
The incidence of obesity-related cancers is rising in Puerto Rico, putting additional pressure on an already stressed health care industry.
The World Obesity Federation’s 2025 World Obesity Atlas projects that the number of adults living with obesity worldwide will increase by more than 115% between 2010 and 2030, from 524 million to 1.13 billion.
In Puerto Rico, obesity prevalence reached between 35% and less than 40% in 2023, higher than the 20% average for the U.S. and its territories, the Centers for Disease Control and Prevention reported this month.
Statista reports an obesity rate of 36% for Puerto Rico, while the World Obesity Federation reports 36.6% — the 20th highest in the world. At 41.6%, the U.S. ranks No. 10.
Obesity-associated cancers in Puerto Rico
People with obesity have a much higher cancer risk — between 10% and seven times higher across multiple types of cancer — than people without obesity, according to the National Cancer Institute.
Obesity-associated cancers include esophageal, upper stomach, colorectal, liver, gallbladder, pancreatic, multiple myeloma, postmenopausal female breast, uterine, ovarian, kidney, meningioma and thyroid cancers.
The incidence of obesity-related cancers in Puerto Rico rose significantly between 2000 and 2022, with an average annual percentage change (AAPC) of 1.4%, while nonobesity-related cancers remained stable, according to a study led by Carola T. Sánchez-Díaz, assistant investigator in the Division of Cancer Control and Population Sciences at the University of Puerto Rico Comprehensive Cancer Center (UPRCCC).
Women under 50 had the highest increase in obesity-related cancers, with 4.9% and 4.6% among those 30 to 39 and 40 to 49 years old, respectively, Sánchez-Díaz said during a presentation at the 18th AACR Conference on the Science of Cancer Health Disparities held earlier this month in Baltimore, as reported by the American Association for Cancer Research.
Women under 40 showed the highest increases in thyroid cancer (6.1%), colorectal cancer (5%) and uterine cancer (4.9%). Among men under 40, the largest increases were thyroid cancer (7.5%), kidney cancer (4.4%) and colorectal cancer (4%). In addition, women aged 40 to 49 experienced significant increases in pancreatic, kidney and ovarian cancers, while men in the same age group showed increases in multiple myeloma.
Sánchez-Díaz pointed out that Puerto Rico’s unique social and environmental context — including economic crises, infrastructure failures, natural disasters and the COVID-19 pandemic — played a role in obesity rates by restricting access to health care, nutritious foods, safe spaces for physical activity and cancer screenings.
Efforts to contact Sánchez-Díaz and the UPRCCC for additional information were unsuccessful.
The economic burden of obesity-related cancers
Rising obesity rates and obesity-related cancers in Puerto Rico can further stress a health care industry already struggling with declining physician numbers, deteriorating infrastructure, the lingering impact of natural disasters and inadequate and inequitable federal funding.
Obesity-related conditions such as cancer, heart disease and type 2 diabetes cost the U.S. health care system about $173 billion a year, the CDC reported in 2024.
A 2025 study showed that the global economic loss and disease burden of obesity-associated cancers amounts to billions of dollars each year, with colorectal cancer leading at $2.6 billion, followed by breast cancer ($1.05 billion) and liver cancer ($1 billion).
According to the Peterson-KFF Health System Tracker, U.S. patients with an obesity diagnosis had $12,588 in average annual health spending, more than double the $4,699 spent by people without obesity or overweight diagnoses.
The American Cancer Society in 2021 reported that long-term cancer survivors with obesity incur $3,000-plus more in annual medical spending versus survivors of normal weight, with those severely obese spending $5,000-plus more.
The excess costs suggest greater use of hospital services by obese patients, including longer stays, repeat admissions, complications, surveillance and therapeutic interventions. From a business standpoint, these added costs can strain hospital margins, especially in systems with fixed reimbursement or bundled payments.
Data and analytics company GlobalData recently reported that obesity and overweight caused $425.5 billion in economic costs to U.S. businesses and employees in 2023, $90 billion of it in higher medical costs to employers, $82.3 billion in absenteeism associated with obesity and $31.1 billion in disability payments.
