The Continuous Update Project: concept, purpose, methods and - - PowerPoint PPT Presentation

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Teresa Norat

August 27-30 2012 Montreal, Canada

The Continuous Update Project: concept, purpose, methods and results

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Continuous Update Project

• Keep Report updated into the future
• WCRF/AICR working with team at
• Same principles:
• Systematically review evidence
• Meta analysis
• Panel of experts
• draw conclusions
• make recommendations
• Various outputs

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Continuous Update Project

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MEMBERS AND OBSERVERS OF THE CUP PANEL

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Alan Jackson (Chair) CBE,MD,FRCP,FRCPCH,FRCPath University of Southampton,UK

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Elisa Bandera, MD, PhD The Cancer Institute of New Jersey United States

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Stephen Hursting PhD MPH University of Texas Austin, TX, USA

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John Milner, PhD (Observer) National Cancer Institute Bethesda, MD United States

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Anne McTiernan, MD, PhD Fred Hutchinson Cancer Research Center Seattle, WA, USA

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Hilary J Powers, PhD RNutr University of Sheffield, UK

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Elio Riboli (Observer) MD, HonFPH, FMedSci Imperial College London,UK

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Ricardo Uauy, MD PhD Instituto de Nutricion y Tecnologia de los Alimentos Santiago, Chile

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The Continuous Update Project – rolling programme

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YEAR

CANCER TYPES

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BREAST

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PROSTATE

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COLON AND RECTUM

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COLON AND RECTUM

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COLON AND RECTUM

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COLON AND RECTUM

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PANCREAS PANCREAS PANCREAS

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BREAST CANCER SURVIVORS BREAST CANCER SURVIVORS

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ENDOMETRIUM ENDOMETRIUM OVARY

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OVARY

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KIDNEY

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2008

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2007 2009 2010 2011 2012

BREAST CANCER SURVIVORS

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17 CANCERS AND CANCER SURVIVORS

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CUP Database

CUP database CUP Team

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Strategic decisions

• 1. Updating the database:

References and abstracts of

• ther relevant studies

Ref Man (Identifiers)

Cohort studies, case-control studies nested in cohort studies Randomised trials Peer-reviewed journals (English language)

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• 2. When to update a meta-analysis?

Three or more publications added after the 2007 second expert report By recommendation of the Panel

Strategic decisions

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100 200 300 400 500 600 700 Breast Colon Prostate Pancreas Endometrial Ovary Bladder Kidney 328 300 236 121 59 45 101 62 323 239 154 82 58 60 33 41

Number of articles from cohort studies in the CUP database for selected cancers by publication period

Search literature review Second expert report (before 2006) Continuous update project (2006-2011)

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Diet and Cancer Report website

http://www.dietandcancerreport.org

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In 2011, the evidence that foods containing dietary fibre modify the risk of colorectal cancer was upgraded from probable to convincing

Colorectal cancer matrices 2007 and 2011

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Colorectal cancer and dietary fibre

per 10 g increase

CUP ¡Colorectal ¡cancer ¡report ¡2010 ¡ ¡ ¡BMJ ¡2011;343:d6617 ¡doi: ¡10.1136/bmj.d6617 ¡ ¡

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Colorectal cancer and dietary fibre (by food source)

CUP ¡Colorectal ¡cancer ¡report ¡2010 ¡ ¡ ¡BMJ ¡2011;343:d6617 ¡doi: ¡10.1136/bmj.d6617 ¡ ¡

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Colorectal cancer and whole grain foods

CUP ¡Colorectal ¡cancer ¡report ¡2010 ¡ ¡ ¡BMJ ¡2011;343:d6617 ¡doi: ¡10.1136/bmj.d6617 ¡ ¡

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Highest ¡ ¡vs ¡Lowest ¡

Dose-­‑response ¡(per ¡100 ¡grams) ¡

Colorectal cancer, fruits and vegetables

Colorectal ¡cancer ¡report ¡2010 ¡ ¡Gastroenterology ¡2011 ¡h6p://dx.doi.org/10.1053/j.gastro.2011.04.013 ¡ ¡

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Colorectal cancer, red and processed meats

CUP ¡Colorectal ¡cancer ¡report ¡2010 ¡PLoS ¡One ¡2011;6(6):e20456 ¡

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ICL Team Journal Publications

q Carbohydrates, glycemic index, glycemic load Cancer Causes

• Control. 2012 Apr;23(4):521-35

q Dietary fibre, whole grains BMJ. 2011 Nov 10;343:d6617. doi: 10.1136/bmj.d6617 q Red and processed meat PLoS One. 2011;6(6):e20456 q Dairy products Ann Oncol. 2012 Jan;23(1):37-45 q Fruits and vegetables Gastroenterology. 2011 Jul;141(1):106-18 q 25-hydroxyvitamin D status Cancer Epidemiol Biomarkers Prev. 2011 May;20(5):1003-16

Colorectal cancer

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q Dietary and blood carotenoids Am J Clin Nutr. 2012 Jul 3 q Fruits and vegetables Breast Cancer Res Treat. 2012 Jun 16 q Dietary fiber Ann Oncol. 2012 Jun;23(6):1394-402

ICL Team Journal Publications

q Height. Cancer Causes Control. 2012 Jun 12 q Dietary fructose, carbohydrates, glycemic index Ann Oncol. 2012 Apr 26 q Body mass index, abdominal fatness Ann Oncol. 2012 Apr; 23(4):843-52

Breast cancer Pancreatic cancer

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Breast cancer and dietary fibre (by food source)

Ann ¡Oncol ¡2012;23:1394-­‑1402 ¡

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What next?

Breast cancer survivors. Mortality, second cancers (Nov 2012)

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What next?

Reports on endometrial and ovarian cancer (October 2012) Timeline:

ICL

JanFeb Mar AprMay JunJul Aug Sep OctNov Dec JanFeb Mar AprMay JunJul Aug Sep OctNov Dec JanFeb Mar AprMay JunJul Aug Sep OctNov Dec JanFeb Mar AprMay JunJul Aug Sep OctNov Dec JanFeb Mar AprMay JunJul Aug Sep OctNov Dec JanFeb Mar AprMay JunJul Aug Sep OctNov Dec Cancers

Breast Prostate Colorectal Adenomas Pancreas Breast Ca Surv Endometrium Ovary Kidney Bladder Liver Gallbladder Stomach Oesophagus MPL Nasopharynx Lung Skin Cervix

2015 2016 2011 2013 2012 2014

Protocol Updating Database Continuous Update Report first draft Report review Report discussed by Panel Panel meeting

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CUP Team Ana Rita Vieira Rui Vieira Teresa Norat Doris Chan Deborah Navarro Rosenblatt Dagfinn Aune Doris Chan Darren Greenwood, University of Leeds, Statistical Advisor (not in photo)

Thanks!