Using imaging to measure body composition may improve cancer risk assessment in postmenopausal women
Research using advanced imaging could improve future cancer risk assessment and prevention strategies
Research scientist, Robert Blew, collaborates with Cancer Center member, Jennifer Bea, in their laboratory at the Abrams Public Health Center.
Joshua Elz
A new study led by a researcher at the University of Arizona Comprehensive Cancer Center found that higher levels of visceral fat in postmenopausal women were linked to a significantly higher risk of obesity-related cancers.
The findings, published in the journal Obesity, suggest that where fat is stored in the body may provide important information beyond traditional measures such as body mass index.
The study examined data gathered by the Women's Health Initiative, which included 9,950 postmenopausal women, and found that visceral fat, which is stored deep in the abdomen around internal organs, was associated with increased risk of 13 obesity-related cancers. This association remained even after accounting for traditional measures such as body mass index (BMI) and waist circumference. The Women's Health Initiative is a long running national health study that enrolled more than 161,000 women beginning in the 1990’s.
"In our study women in the highest quartile of visceral fat had nearly double the risk of obesity-related cancer risk compared with those in the lowest quartile," said Jennifer Bea, PhD, the study's senior author and co-leader of the U of A Cancer Center’s Cancer Prevention and Control Program. Bea is also a professor in the U of A College of Medicine and Zuckerman College of Public Health.
Jennifer Bea, PhD
The 13 obesity-related cancers include breast, colorectal, endometrial, esophageal, gallbladder, kidney, liver, multiple myeloma, meningioma, pancreatic, ovarian, thyroid and upper stomach cancer. “These cancers are known to be linked to excess adiposity, but our study suggests that where fat is stored in the body may also matter, especially in postmenopausal women,” Bea said.
Bea’s team, including first author, Robert M. Blew, a research scientist with the Zuckerman College of Public Health and the School of Nutritional Sciences and Wellness, used dual-energy X-ray absorptiometry (DXA) scans, commonly used to measure bone density, along with specialized software to quantify visceral and subcutaneous fat in the abdomen. The study analyzed Women’s Health Initiative data from 9,950 postmenopausal women who were followed for up to 27 years.
“Because cancer can take years to develop, long term follow-up is essential,” Blew said. “In this study, the Women’s Health Initiative followed nearly 10,000 postmenopausal women over many years, giving us a strong foundation to examine how visceral fat was associated with obesity-related cancer risk over time.”
While the study also showed that subcutaneous fat, which lies just under the skin, was associated with cancer risk, the effect was more modest than that observed for visceral fat. The ratio of visceral to subcutaneous fat also provided additional information about risk.
"What's particularly important is that visceral fat remained strongly associated with cancer risk even after accounting for BMI and waist circumference," Bea said. "This suggests that where fat is stored in the body may provide important information beyond body weight alone."
About 37% to 43% of study participants were classified differently when visceral fat measurements were compared with traditional measures like body mass index and waist circumference, highlighting the potential value of more precise tools.
"These results suggest that incorporating imaging-based body composition measures could help clinicians and researchers better identify individuals at higher risk for obesity-related cancers," Bea said. "With further study, this more targeted approach may help inform how we assess obesity-related cancer risk, particularly for postmenopausal women."
The study's findings were consistent across different age groups, body mass index categories, and racial and ethnic populations, suggesting potential generalizability among postmenopausal women.
“As we work to improve cancer prevention, studies like this suggest that more precise measures of body composition may help us better identify postmenopausal women at higher risk for obesity-related cancers,” Blew said.