# Adipose and Lean Soft Tissue Depots, Cancer Risk and Mortality in Postmenopausal Women

> **NIH NIH R01** · UNIVERSITY OF ARIZONA · 2022 · $172,694

## Abstract

ABSTRACT
Obesity, classified by BMI (body weight/height2) is associated with higher risk of at least 12 cancers in
postmenopausal women. Yet, BMI is a particularly blunt tool to understand the etiology of body composition
contributions to cancer risk, and actually identify causal targets for intervention and cancer prevention. This is
because BMI does not address the central hypothesis underlying the obesity-cancer association- that higher
levels of abdominal visceral adipose tissue (VAT), which accumulates to a greater extent post menopause in
the intra-abdominal cavity, drives the pathophysiology of obesity-related cancers via its role in inflammatory,
metabolic, and immune dysfunction - hallmarks of cancer. Whereas adipose tissue just under the skin
(subcutaneous, SAT) may even be benign. BMI also does not delineate between fat and muscle (i.e. lean soft
tissue, LST), which has the potential to ameliorate dysfunction in these VAT driven pathways. Nevertheless,
muscle has not been examined in relation to tumorigenesis, though it is emerging as an important component
of survival. Despite the increase in obesity-related cancers and burgeoning research triangulated to inform the
carcinogenic VAT hypothesis, the hypothesis is effectively untested. This proposal is of particular significance
because the evidence base lacks sufficiently powered studies that are able to examine both detailed body
composition and anthropometric exposures simultaneously in relation to cancer incidence and mortality. This
reflects the historical prohibitive cost, availability, and radiation exposure associated with measuring specific
abdominal adipose tissue depots by CT and MRI. Recent advances in Dual Energy X-Ray Absorptiometry
(DXA) technology, validated against CT and MRI, have allowed us to quantify abdominal VAT and SAT from
existing DXA scans within the well-characterized Women's Health Initiative (WHI). We will similarly measure
abdominal LST, to complement the total body measures available, in this prospective cohort of nearly 11,000
women with repeated DXA measurements at baseline and 3, 6 and 9 years later. We will examine how levels
of abdominal VAT, SAT and LST, as well as total body composition and anthropometry, associate with obesity-
related cancer incidence and mortality. Moreover, we will examine these body composition measures in
relation to lung cancer, (not classified as obesity-related) to address anomalies in the literature, i.e. BMI
(inverse) and waist (positive) associations with lung cancer. We hypothesize that VAT, in the context of other
tissues, is a risk factor, for all cancers. This wholly unique dataset with adjudicated outcomes over 25 years will
provide novel insight into the etiological role of the aforementioned abdominal adipose tissue depots and LST
in cancer risk and cancer mortality. We will use a comprehensive, rigorous analytic approach to address our
aims and hypotheses. The study will inform and alter clinical practice beyond...

## Key facts

- **NIH application ID:** 10524186
- **Project number:** 3R01CA253302-03S1
- **Recipient organization:** UNIVERSITY OF ARIZONA
- **Principal Investigator:** Jennifer Wright Bea
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $172,694
- **Award type:** 3
- **Project period:** 2020-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10524186

## Citation

> US National Institutes of Health, RePORTER application 10524186, Adipose and Lean Soft Tissue Depots, Cancer Risk and Mortality in Postmenopausal Women (3R01CA253302-03S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10524186. Licensed CC0.

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