A 55-year-old woman has been steadily gaining weight for the past 30 years. She underwent cholecystectomy for cholelithiasis 5 years ago. She does not smoke. She is now 164 cm (5 ft 4 in) tall and weighs 126 kg (BMI 47). On physical examination, she has a decreased range of motion with pain on movement of the knees. Laboratory studies show a serum glucose level of 176 mg/dL. This patient is at greatest risk of developing which of the following neoplasms?

This patient is morbidly obese. The extra weight puts a strain on joints, particularly the knees, increasing the risk for osteoarthritis. Although the overall risk of cancer increases with obesity, the relationship between endometrial carcinoma and obesity is well established. About 80% of individuals with type 2 diabetes mellitus are obese. The relationship between diet and obesity to colon cancer is not as well established. Worldwide, most hepatocellular carcinomas arise in individuals infected with hepatitis B; chronic alcoholism also is a risk factor. Pulmonary adenocarcinoma is the least likely bronchogenic cancer to be associated with smoking. Some renal cell carcinomas are associated with smoking.