Can Exercise Lower Lung Cancer Risk?
Expert Perspectives · Keira Smith · 2026-05-29
At the American Association for Cancer Research (AACR) Annual Meeting, Dr. Marisa Bittoni of The Ohio State University Comprehensive Cancer Center shared interim findings from the BEFIT study, a pilot exercise intervention for people at high risk for lung cancer. Rather than focusing on patients already diagnosed with disease, the study targets a vulnerable group—longtime smokers and former smokers eligible for lung cancer screening—to explore whether structured exercise can improve fitness, reduce body mass index, and potentially influence inflammation and the microbiome.
Why Lifestyle Matters in Lung Cancer Risk
Dr. Bittoni emphasized that modifiable lifestyle factors are increasingly recognized as meaningful contributors to lung cancer risk reduction. While smoking remains the dominant driver, healthier behaviors may still have measurable protective effects. “There’s actually quite a bit of evidence showing that there is a reduced risk of lung cancer with a healthier diet, particularly fruit and vegetables,” she said, pointing to the Mediterranean diet as one well-studied example.
Exercise, she noted, may be even more biologically relevant than many people assume. “It’s not just that it’s good for you or that it helps you be healthier, but it literally can help target the cancer process,” she explained. That framing reflects a growing scientific interest in how physical activity may affect pulmonary function, systemic inflammation, and even cancer progression at the cellular level.
Inside the BEFIT Study
The BEFIT study was designed as a randomized controlled pilot trial involving 40 participants recruited primarily from Ohio State’s lung screening clinic, with additional outreach through Facebook using the same eligibility criteria. Participants were adults aged roughly 50 to 80 with significant smoking histories, placing them at elevated risk for lung cancer.
Over 12 weeks, participants were randomized either to an exercise intervention with a cognitive behavioral component or to a usual-care control group that received educational literature about exercise. The intervention itself combined resistance training twice weekly with 150 minutes of aerobic activity per week, following American College of Sports Medicine guidelines. Importantly, the aerobic component was flexible: walking, dancing, and gardening all counted.
The program was also fully virtual, reflecting lessons learned during the COVID era. Dr. Bittoni noted, “Since COVID, that has been one thing that we have found we don’t need to do in person. It’s actually easier for people to do it at home, in their comfort of their home.” Participants received resistance bands and worked with trainers who gradually tapered supervision so individuals could transition toward exercising independently.
Recruitment Challenges
Like many prevention studies, BEFIT faced recruitment and retention hurdles. Dr. Bittoni described the population candidly as older longtime smokers, many of whom had complex health histories and were not already highly active. Yet one of the study’s biggest surprises was that the intervention group proved easier to retain than the control group.
“I guess they had to be invested in that exercise part, because the people that exercised did come back,” she said. “They did show up once we got them in.” To meet enrollment goals, the team extended recruitment by nearly a year, increased compensation, and loosened some inclusion criteria with institutional review board (IRB) approval. Still, the experience offered an important practical lesson: when participants feel engaged in a meaningful intervention, adherence may be stronger than expected.
Interim Results Show Meaningful Gains
The interim findings presented at AACR were encouraging. Overall intervention adherence was about 82%, which Dr. Bittoni described as moderate and respectable for this high-risk population. The study also found a significant reduction in body mass index (BMI) in the intervention arm compared with controls, along with improvements in baseline fitness testing.
Physical activity increased significantly across walking, moderate, vigorous, and total activity measures in the intervention group. Just as notable were the behavioral shifts. The team observed gains in self-efficacy, behavioral intention, action planning, and action control—factors that could matter for sustaining exercise over the long term.
Dr. Bittoni underscored why even these early results matter: “Even the improvements in the physical activity and lowering the BMI are reducing their lung cancer risk, or any cancer risk.” Analyses of inflammatory markers and microbiome changes are still pending, but those data may further clarify the biological pathways behind the benefits.
A Promising Signal for Prevention Research
For Dr. Bittoni, one of the most important outcomes was proving feasibility in a group that many might underestimate. “We had people say, ‘Oh, you’ll never get these people to do this program. You’ll never get these longtime smokers to exercise.’ Well, we did prove them wrong.” That success may have implications beyond this single pilot study. It suggests that even among older adults with substantial smoking histories, a flexible, home-based, behaviorally supported exercise program can work.
If future analyses confirm favorable changes in inflammation and the microbiome, BEFIT could help build the case for exercise not just as a general wellness recommendation, but as a targeted cancer prevention strategy in high-risk populations.
Key Takeaways
The BEFIT study evaluated a 12-week virtual exercise intervention in people at high risk for lung cancer.
Participants in the intervention group showed significant increases in physical activity and a significant reduction in BMI.
The study also found improvements in self-efficacy and other behavioral measures tied to long-term exercise adherence.
Recruitment took longer than expected, but adherence among intervention participants was strong at about 82%.
Pending microbiome and inflammation analyses may offer deeper insight into how exercise biologically reduces cancer risk.
About Dr. Bittoni
Marisa Bittoni, PhD, MS, BS, is an Assistant Professor of Internal Medicine at The Ohio State University Comprehensive Cancer Center, where she conducts research in the Molecular Carcinogenesis and Chemoprevention Research Program. Dr. Bittoni’s focuses on the effects of lifestyle risk factors, including diet, exercise, and smoking, on lung cancer prevention and survival. She is particularly interested in the effects of inflammatory biomarkers on lung cancer risk and interrelationships with the microbiome.