The Continuous Update Project: Introduction to the Project21 October 2015Martin WisemanWorld Cancer Research Fund International & University of Southampton

Who we are What we doFund research on the relationship of nutrition,

physical activity and body weight to cancer risk

Interpret the accumulated scientific literature to derive Recommendations for Cancer Prevention

Educate people through our national Health Information programmes

Advocate effective policies to help people and populations to reduce their chances of developing cancer

AICR WCRF UK WCRF Netherlands WCRF HKWCRF International

1. New method2. Systematic reviews3. Review of evidence separate from

judgement 4. Panel of international experts5. Predetermined criteria for judgements

EpidemiologyMechanisms

6. Flexibility7. Continuous update of evidence

WCRF/AICR EXPERT REPORT The most authoritative

NUTRITION AND CANCERS

• OBESITY– BREAST (PM), COLORECTUM, ENDOMETRIUM, OESOPHAGUS, PANCREAS,

GALLBLADDER, KIDNEY, LIVER, OVARY, ADVANCED PROSTATE

• PHYSICAL ACTIVITY– COLON, POSTMENOPAUSAL BREAST, ENDOMETRIUM

• MEAT – RED AND PROCESSED– COLORECTAL

• ALCOHOL – MPL, BREAST, COLORECTUM, LIVER

• FRUIT AND VEGETABLES– MPL, OESOPHAGUS, STOMACH, COLORECTAL (DF), LUNG

• BREASTFEEDING– BREAST (MOTHER), OBESITY (CHILD)

The Panel emphasises the importance of not smoking and of avoiding exposure to tobacco smoke

The Continuous Update Project. Aims

Ensure everyone has accessBased on the most up to date scientific evidence

WCRF/AICR Recommendations for Cancer Prevention:

• Keep evidence, conclusions and recommendations updated into the future• Working with team at ICL• Same principles: - Systematically review evidence- Meta analysis - Panel of experts

- draw conclusions - make recommendations

Continuous Update Project (CUP)

What is the Continuous Update Project?

Continuous update epidemiologic evidence (SLR- Imperial College London)

Up-to-date database

Mechanistic evidence (University of Bristol)

Evaluation of evidence (Independent panel of experts)

Recommendations

Education, policy and research priorities

The Continuous Update Process

Continuous update epidemiologic evidence (SLR- Imperial College London)

CUP Search Literature Review PROTOCOL(SLR- Imperial College London)

Research topic :The associations between food, nutrition and physical activity and Cancer risk Mortality and second cancers in breast cancer survivors.

Main objective :Summarize the evidence from prospective studies and randomised controlled trials (case-control studies if requested by the Panel).

Search strategy:Medline, Central, ClinialTrials.govHand search of references (reviews, meta-analysis, recent relevant papers)

(http://www.dietandcancerreport.org/cancer_resource_center/downloads/SLR_Manual.pdf)

One central database for cancer prevention research

Team

Database

CUP Expert PanelWCRF Secretariat

Statistical methods

Dose-response meta-analysis using generalized least-squares for trend estimation (command GLST in Stata)

Statistical methods

Publication bias Exploratory analyses

Statistical methods

Stratified analyses, sensitivity analyses

Until 2016 - Rolling programme of updates- Cancer by cancer

2016-2017 – Panel review evidence for all cancers

2017 – Statement to be published on evidenceFrom 2017 – continue to update and review

evidence

Plan of work

Year Publications2010 Breast2011 Colorectum2012 Pancreas2013 Endometrium2014 Ovary, prostate and breast cancer

survivors2015 Liver, kidney, gallbladder, bladder 2015-2016

Stomach, oesophagus, lung

2016-2017

Breast, colorectum

2017 Major report – Recommendations

Timeline

CUP database

CUP report downloads

Total downloads: 4273 vs. 806

Journal articles

Includes articles published by ICL (13), WCRF (1), UEA (1) + breast cancer survivors

The Continuous Update ProjectExpert Panel

www.wcrf.org/int/research-we-fund/continuous-update-project-cup