Excess abdominal fat may increase patients’ risk of developing non-small cell lung cancer, according to a study published June 29 in the Journal of Thoracic Oncology.
Researchers from Buffalo, N.Y.-based Roswell Park Comprehensive Cancer Center analyzed data from 1,170 current or former smokers. Researchers compared two groups: 576 patients treated surgically for stage 1 or 2 non-small cell lung cancer at Roswell Park between 2009 and 2020, and 576 patients who underwent lung cancer screening at Roswell Park between 2015 and 2022.
Both groups underwent CT scans measuring total fat area in the abdominal region. Among the healthy but high-risk group, those with relatively high total fat area were more likely to develop lung cancer than those with lower total fat area.
Sai Yendamuri, MD, chief strategy officer, senior vice president and chair of thoracic surgery at Roswell Park, shared with Becker’s what these findings mean for clinical and preventive cancer care.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What does this finding suggest about how obesity or metabolic risk factors should be incorporated into risk stratification or screening criteria?
Dr. Sai Yendamuri: This is not actionable at this level yet. The most common way of measuring obesity is using the body mass index, which is not very accurate in measuring visceral obesity. In our study, we used CT scan-based measures of obesity. This is one of our big insights — we need to incorporate more accurate measures of obesity into clinical practice.
Q: How far out is targeting obesity-driven immune dysfunction from being something health systems could realistically build into a treatment or prevention pathway?
SY: Based on our data, we are conducting phase 2 lung cancer interception trials to target this specific population. We have just completed one such trial using metformin as an immunomodulatory agent. Further work with large phase 3 trials needs to be done before incorporation into standard clinical care.
Q: Given that nearly two-thirds of the U.S. population now has an elevated BMI, what’s the practical takeaway for hospital leaders?
SY: It is now increasingly clear that obesity management, nutrition and exercise are an integral part of cancer care, and not just for the traditional “13 obesity-related cancers.” Many cancer centers are making this part of their Functional Medicine programs. Our study provides additional strong rationale for such programs.
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