ASCO 2026 | The association between elevated red cell distribution width-to-albumin ratio & incident cancer risk
In this video, Parham Habibzadeh, MD, University of Pittsburgh, Pittsburgh, PA, discusses the findings of a prospective cohort study examining the association between elevated red blood cell distribution width-to-albumin ratio (RAR) and incident cancer risk, highlighting that a high RAR can predict cancer development, particularly for hematological malignancies and some solid cancers. Dr Habibzadeh notes the accessibility of this prognostic biomarker, as it can be calculated using values present on a routinely performed standard blood panel. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
This study looked at something that is already sitting in many of our patients’ blood work, but we tend to overlook. It’s called RAR, red cell distribution width to albumin ratio. Let me unpack this. Red cell distribution width is basically a measure of how uneven red blood cells are in size. It tends to increase when our body is under stress or inflammation...
This study looked at something that is already sitting in many of our patients’ blood work, but we tend to overlook. It’s called RAR, red cell distribution width to albumin ratio. Let me unpack this. Red cell distribution width is basically a measure of how uneven red blood cells are in size. It tends to increase when our body is under stress or inflammation. Albumin is a protein that reflects our body’s nutritional or stress status. You get a single number when you combine the two in this index called RAR which basically reflects our body’s inflammation and also the body’s reserves. We wanted to know, in healthy people, does a high RAR today predict cancer down the road. So again we use the UK Biobank and we found that people who have an elevated RAR today predict cancer down the road.
So again, we use the UK Biobank and we found that people who have an elevated RAR had also a higher risk of developing cancer. But the interesting story is which cancers? What we found was the strongest links were with blood cancers like leukemia or cancers of stomach, liver, lung, and colon. And more importantly, when we excluded the first two years to make sure we weren’t just picking up cancers that were already present, the association barely changed. That tells us RAR is genuinely pointing forward in time and not just picking hidden diseases. The big appeal here is accessibility. This isn’t an expensive new test. It’s basically two numbers already on a standard blood panel. So the real promise is using something we already measure to help flag patients who might warrant closer attention.
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