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449 Content in this section does not refl ect any offi cial policy or medical opinion of the American Cancer Society or of the publisher unless otherwise noted. © American Cancer Society, 2018. N research presented at the European Society for Medical Oncology 2017 Congress, held September 8 to 12, 2017, in Madrid, Spain, fi nds that body fat distribution in the trunk is more important than body weight when it relates to cancer risk in postmenopausal women. According to study investigator Line Mærsk Staunstrup, a PhD student with Nordic Bioscience and ProScion in Herlev, Denmark, these fi ndings indicate that body mass index and fat percentage may not be adequate for assessing cancer risk among postmenopausal women because these measures fail to assess the distribution of fat mass. Instead, avoiding central obesity may be the best protection. Th e results are taken from the Prospective Epidemiological Risk Factor study, an observational, prospective cohort study designed to gain a better understanding of Danish, age-related postmenopausal women. Th e study included 5855 women (mean age, 71 years) who underwent baseline dual-energy X-ray absorptiometry scans to assess body fat and body fat composition and then were followed for 12 years. Researchers used information from national cancer registries to record 811 solid cancers in the women, indicating that the ratio of abdominal fat to peripheral fat was a signifi cant independent predictor of cancer diagnosis up to 12 years after baseline. Neither body mass index nor fat percentage was shown to have signifi cance. Among the cancers studied were 293 breast and ovarian cancers, 345 lung and gastrointestinal cancers, and 173 other cancers. Examining in detail specifi c cancers and risk factors, the investigators determined that only lung and gastrointestinal cancers were associated with high abdominal-to-peripheral fat ratios. Other risk factors included older age, receipt of hormone replacement therapy, and smoking, but after controlling for these, the fat ratio remained an independent risk factor. Th e fi ndings underscore the need for women to be aware of lifestyle as they approach menopause, because women in this age group are prone to abdominal weight gain, says Mærsk Staunstrup. She adds that clinicians can use the information to initiate conversations regarding prevention with patients who are at a higher risk of developing cancer. Commenting on the study, Andrea De Censi, MD, of Galliera Hospital in Genoa, Italy, points out that increases in insulin that result from the overconsumption of simple carbohydrates tend to result in fat accumulation that is specifi cally visceral and abdominal. Insulin also can have detrimental eff ects on hormone production, and adipose cells in fat tissue increase chronic infl ammation throughout the body, which is another risk factor for several cancers, he says. Interventions such as diet and exercise, and potentially the diabetes drug metformin, may lower such eff ects and help to reduce cancer risk, he adds.