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Evidence-based recommendations for prevention
of cancer and other chronic diseases
The 2007 and 2009 WCRF/AICR Reports

Martin Wiseman
World Cancer Research Fund International
University of Southampton, UK

www.wcrf.org/ICN2013
IUNS, Granada, 2013
Who we are
AICR
WCRF UK
WCRF Netherlands
WCRF Hong Kong
WCRF International

What we do
Fund 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
Data from Parkin et al, Pisani et al, Globocan 2008, IARC
*Estimated new cases for 2030 from predictions in 2002
USA

UK

BRAZIL

CHINA

Mouth, pharynx,
larynx

63

67

63

44

Oesophagus

69

75

60

44

Lung

36

33

36

38

Stomach

47

45

41

33

Pancreas

19

15

11

8

Gallbladder

21

16

10

6

Liver

15

17

6

6

Colorectum

50

47

41

22

Breast

38

42

28

20

Endometrium

59

44

37

25

Prostate

11

20

N/A

N/A

Kidney

24

19

13

8

Total for these
cancers

35

37

29

27

Total for all
cancers

24

27

19

22

Around one quarter
of all cancers
estimated avoidable
through appropriate
food, nutrition and
physical activity
Global variation in cancer incidence and
impact of migration

Breast

Colorectum
Environment
is a key determinant
of cancer patterns
Why nutrition?
Epidemiology links food, nutrition and
physical activity to cancer
Experimental evidence links nutrition and
cancer
WCRF/AICR EXPERT REPORT
1.
2.
3.
4.
5.

The most authoritative
New method
Systematic reviews
Review of evidence separate from
judgement
Panel of international experts
Predetermined criteria for judgements
Epidemiology
Mechanisms

6. Flexibility
7. Continuous update of evidence
NUTRITION AND CANCERS
OBESITY
BREAST (PM), COLORECTUM, ENDOMETRIUM, OESOPHAGUS,
PANCREAS, GALLBLADDER, KIDNEY

PHYSICAL ACTIVITY
COLON, BREAST, OBESITY

MEAT – RED AND PROCESSED
COLORECTAL

PLANT FOODS
MPL, OESOPHAGUS, STOMACH,) COLORECTAL, LUNG, OBESITY

ALCOHOL
MPL, COLORECTUM, LIVER, BREAST

SALT
STOMACH

BREASTFEEDING
BREAST, EXCESS WEIGHT GAIN (CHILD)
The Panel emphasises the
importance of not smoking and of
avoiding exposure to tobacco smoke
Continuous Update Project
(CUP)

• 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
Novel aspects of CUP
1. Breast Cancer Survivors
2. Mechanisms
Cancer prevention
What to do…?
What determines
people’s behaviour?
How to change it?
Behaviour
• People behave like those around them
– social norms

• Asking people to behave very differently
from their social norm only has limited or
unsustained effect
• Personal choice determines individual
variation around the social norm
– small effect

• External factors determine social norms
– big effect
Everybody has a role
to play
Action needs to be
coherent
Leadership from
Government
Health professionals
Conclusions
The WCRF/AICR Expert Reports, and the CUP, are the
most rigorous and authoritative reviews available.
They conclude that
•

Cancer is a major cause of death, disability and lost life years

•

Cancer is mostly environmentally determined and largely
preventable

•

With smoking, food, nutrition, body fatness and physical activity
are the most important factors affecting cancer risk

•

Evidence to support this comes from many different sources

•

Preventing cancer through food, nutrition and physical activity will
also prevent other major chronic diseases

•

Changes are needed in people’s environment as well as
in personal choices
www.dietandcancerreport.org/CUP

www.wcrf.org/ICN201

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WCRF Report Recommends Cancer Prevention Through Diet, Nutrition and Physical Activity

  • 1. Evidence-based recommendations for prevention of cancer and other chronic diseases The 2007 and 2009 WCRF/AICR Reports Martin Wiseman World Cancer Research Fund International University of Southampton, UK www.wcrf.org/ICN2013 IUNS, Granada, 2013
  • 2. Who we are AICR WCRF UK WCRF Netherlands WCRF Hong Kong WCRF International What we do Fund 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
  • 3.
  • 4. Data from Parkin et al, Pisani et al, Globocan 2008, IARC *Estimated new cases for 2030 from predictions in 2002
  • 6. Global variation in cancer incidence and impact of migration Breast Colorectum
  • 7. Environment is a key determinant of cancer patterns Why nutrition?
  • 8. Epidemiology links food, nutrition and physical activity to cancer
  • 9. Experimental evidence links nutrition and cancer
  • 10. WCRF/AICR EXPERT REPORT 1. 2. 3. 4. 5. The most authoritative New method Systematic reviews Review of evidence separate from judgement Panel of international experts Predetermined criteria for judgements Epidemiology Mechanisms 6. Flexibility 7. Continuous update of evidence
  • 11. NUTRITION AND CANCERS OBESITY BREAST (PM), COLORECTUM, ENDOMETRIUM, OESOPHAGUS, PANCREAS, GALLBLADDER, KIDNEY PHYSICAL ACTIVITY COLON, BREAST, OBESITY MEAT – RED AND PROCESSED COLORECTAL PLANT FOODS MPL, OESOPHAGUS, STOMACH,) COLORECTAL, LUNG, OBESITY ALCOHOL MPL, COLORECTUM, LIVER, BREAST SALT STOMACH BREASTFEEDING BREAST, EXCESS WEIGHT GAIN (CHILD)
  • 12. The Panel emphasises the importance of not smoking and of avoiding exposure to tobacco smoke
  • 13. Continuous Update Project (CUP) • 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
  • 14. Novel aspects of CUP 1. Breast Cancer Survivors 2. Mechanisms
  • 15. Cancer prevention What to do…? What determines people’s behaviour? How to change it?
  • 16.
  • 17. Behaviour • People behave like those around them – social norms • Asking people to behave very differently from their social norm only has limited or unsustained effect • Personal choice determines individual variation around the social norm – small effect • External factors determine social norms – big effect
  • 18.
  • 19. Everybody has a role to play Action needs to be coherent Leadership from Government Health professionals
  • 20. Conclusions The WCRF/AICR Expert Reports, and the CUP, are the most rigorous and authoritative reviews available. They conclude that • Cancer is a major cause of death, disability and lost life years • Cancer is mostly environmentally determined and largely preventable • With smoking, food, nutrition, body fatness and physical activity are the most important factors affecting cancer risk • Evidence to support this comes from many different sources • Preventing cancer through food, nutrition and physical activity will also prevent other major chronic diseases • Changes are needed in people’s environment as well as in personal choices

Hinweis der Redaktion

  1. Just a note about who does what within our organisation. The charitable fundraising and information programs are conducted at a national level in four countries. And then there is the part I work for – WCRF International – which provides strategic guidance to the charities and conducts most of the science and policy work.
  2. November 1st will see the publication of the WCRF/AICR Expert Report, Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective. The report synthesizes evidence from a vast body of research, grades the quality of that evidence, and draws a series of comprehensive cancer prevention goals for populations and practical recommendations for people. It is a remarkable achievement and yet, as you will see, it is only the beginning.
  3. For breast cancer the number of papers published in the last 6 years is about the same number as published in the previous 50 years. The CUP numbers include all those entered by end 2011
  4. For more information refer to websites.363=/ +=4u6y5t5