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MARTIN WISEMAN World Cancer Research Fund International World Cancer Congress August 2012
A basis for cancer prevention and control worldwide
Continuous Update Project A basis for cancer prevention and control - - PowerPoint PPT Presentation
Continuous Update Project A basis for cancer prevention and control - - PowerPoint PPT Presentation
Continuous Update Project A basis for cancer prevention and control worldwide MARTIN WISEMAN World Cancer Research Fund International World Cancer Congress August 2012 Journal citations - WCRF/AICR Reports 500 450 400 350 Number of
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Journal citations - WCRF/AICR Reports
50 100 150 200 250 300 350 400 450 500 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Number of citations Doll & Peto 1981 1997 EXPERT REPORT 2007 EXPERT REPORT
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Breast
Global variation in cancer incidence
Colorectum
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Migration data
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Around one third of the commonest cancers estimated avoidable through appropriate food, nutrition and physical activity
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Number of papers from cohort studies by year and cancer type
0" 20" 40" 60" 80" 100" 120" 140" 160" 180" 200" 1980" 1982" 1984" 1986" 1988" 1990" 1992" 1994" 1996" 1998" 2000" 2002" 2004" 2006" 2008" 2010" Number Breast" Colorectum" Prostate" Pancreas" Endometrium" Ovary"
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Everybody has a role to
play Action needs to be coherent Leadership from Government Health professionals
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Examples of 2007 WCRF/AICR Expert Report impact
q Norwegian Dietary Guidelines q CRUK Prevention estimates
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Novel aspects of CUP
q Breast Cancer Survivors q Mechanisms
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Novel aspects of CUP
q Breast Cancer Survivors q Mechanisms
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Inclusion criteria
q Survivors of prim
Survivors of primary bre ry breast c st canc ncer r
q Food, nutrition, physic
Food, nutrition, physical a l activity, nutrition- tivity, nutrition- re rela late ted c d com
- mple
plementa ntary m ry medic dicine ine
q R
Random ndomise ised c d controlle
- ntrolled tria
d trials ls
- during a
during and a nd afte fter the r thera rapy for prim py for primary bre ry breast st canc ncer r
q Obse
Observa rvationa tional studie l studies - s - exposure
xposure a asse ssessm ssment nt
- be
before fore prim primary bre ry breast c st canc ncer dia r diagnosis gnosis (c (childhood, a hildhood, adole dolesc scenc nce, a , adulthood) dulthood)
- at dia
t diagnosis gnosis
- during the
during thera rapy py
- afte
fter the r thera rapy py
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Outcomes
q All-c
ll-cause use m morta
- rtality
lity
q Bre
reast c st canc ncer m r morta
- rtality
lity
q Se
Second prim
- nd primary bre
ry breast c st canc ncer r
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Novel aspects of CUP
q Breast Cancer Survivors q Mechanisms
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Raise standards for preclinical cancer research
- C. Glenn Begley and Lee M. Ellis propose how methods, publications and
incentives must change if patients are to benefit.
Many landmark findings in preclinical oncology research are not reproducible, in part because of inadequate cell lines and animal models.
- S. GSCHMEISSNER/SPL
29 MARCH 2012 | VOL 483 | NATURE | 531
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Mechanisms Protocol Development Group
External Experts
q Stephen Hursting (chair) q Andrew Dannenberg q Johanna Lampe q Henry Thompson q Steven Clinton q Nikki Ford - associate
member
WCRF Team
q Martin Wiseman q Susan Higginbotham q Rachel Thompson q Rachel Marklew q Kate Allen q Deirdre McGinley-Gieser
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Cancer: A Complex Process
∞
Inflammation Genomic instability Tissue invasion and metastasis Limitless replicative potential Sustained angiogenesis Evading growth suppression, apoptosis and immune surveillance Dysregulated growth signals and cellular energetics
Adapted from: Hanahan & Weinberg, Cell (2000) and Cell (2011)
✔ ✔ ✔ ✔ ✔ ✔ ✔
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Adapted from: IARC List of Mechanistic Targets
Revised IARC List of Mechanistic Targets (with Hanahan and Weinberg)
1. Genomic instability 2. DNA damage/repair (specify) 3. Gene mutation (specify) 4. Epigenetic markers (specify) 5. Gene expression/miRNA changes (specify) 6. Serum hormones/growth factors (specify) 7. Urinary or tissue metabolite 8. Inflammation
- a. Cytokines (specify)
- b. Tissue markers (specify)
- c. Histological classification (specify)
- 9. Cell proliferation markers (specify)
- 10. Immunologic effects (specify)
- 11. Invasion/metastasis process (specify)
- 12. Angiogeneic effects (specify)
- 13. Cell signaling effects (specify)
- 14. Cell energetics effects (specify)
- 15. Differentiation (specify)
- 16. Cell death (apoptosis/autophagy/necrosis)
- 17. Replicative potential/ Stem cell enrichment
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Mechanisms
q Reviews to be systematic and peer
reviewed
q Reviews conducted by exposure q Pre-feasibility pilot q Feasibility test of final draft protocol by
external group, including peer review
q External review team should have
expertise in informatics, stats, cancer biology, cancer site, nutrition
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How to manage vast body of evidence
q Consider limiting reviews to more
recent publications when abundant evidence
q Consider early exclusion of
inappropriate models
q Use informatics expert
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Timeline
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Conclusions
q The 2007 WCRF/AICR Report remains the
most authoritative review in the area
q The CUP maintains the currency of the
conclusions and recommendations
q Together these provide a firm basis for
public health and policy actions to prevent cancer, and other chronic diseases, worldwide
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