Health research saves lives. But a truth that many people don’t realise is that most of the science that guides global health policy comes from just a handful of regions – mainly high-income countries.
As a result, billions of people, including those in sub-Saharan Africa, live with diseases that are not fully understood within their own cultural, environmental, and biological context.
As a Ghanaian nutrition and public-health scientist who has worked on large, multi-partner studies – including the African Breast Cancer Screening (ABCS) study – I have seen both the obstacles and the immense potential of African-led research. And that potential is what gives me hope.
This blog explores both sides: the reality of building research in systems that are still developing, and the incredible opportunity we have to generate science that truly serves a global purpose.
- Why Africa needs its own data
- Why the data gap exists — and why it can change
- ABCS: science against the odds
- Turning challenges into opportunities
- Building lasting cancer research capacity
- Conclusion: the future is ours to build
Why Africa needs its own data
Most screening tools and risk models used on our continent were developed for populations other than African. This is not limited to cancer, but also other Non-Communicable Diseases.
The global evidence-base linking diet, lifestyle, and cancer risk from the WCRF/AICR reports to physical activity guidelines is built mainly on European, North American, and Asian cohorts. These studies have shaped what the world believes about healthy eating, physical activity, body weight, and cancer. But Africa is different.
- Our food systems blend traditional staples with rapidly increasing ultra-processed foods.
- Our physical activity is often work-related or transport-related, not gym-based.
- And our nutrition transition is unlike what is seen elsewhere.
In 1993, nutrition scholar Barry Popkin explained how our diets evolve as societies change. In high-income countries, this happened slowly as people have gradually moved from traditional meals to more energy-dense, ultra-processed foods. But in many African countries, this shift is taking place at an astonishing pace.
The result is what public health experts call the double burden of malnutrition: undernutrition and overweight sitting side-by-side in the same communities, the same families, and sometimes even the same individuals. There’s also an additional outcome, diet-related chronic diseases like diabetes and hypertension, creating a third layer of complexity.
Africa’s nutrition story is no longer just about hunger. It’s about the collision of old challenges with new ones, all unfolding in a food system that is changing faster than ever before.
Understanding these interconnected drivers demands research that is grounded in African settings and led by African scientists who understand the context. Tackling health inequity also requires tackling data inequity. In short, African solutions need African data.
Professor Francisca Mutapi’s community-embedded schistosomiasis research in Africa generated the evidence that ultimately led the WHO to revise its paediatric treatment guidelines – proof that locally grounded African science can shift global policy.
If global evidence is the goal, then Africa must be genuinely represented not as an afterthought, but as an equal contributor.
Why the data gap exists — and why it can change
People often ask: “Why is it so hard to conduct research in Africa, specifically Sub-Saharan Africa?” Maybe hard is too strong a word. Challenging is more acceptable, and I know every continent presents its own challenges and opportunities.
However, the simple answers to the challenges are familiar: limited funding, infrastructure gaps, bureaucratic delays.
1. Research has not been a political priority.
Many African governments are focused on immediate needs: water, electricity, roads, the growing climate shocks, and ever-persisting food security. These are pressing, real issues.
Research often feels secondary, even though it is the foundation of effective policy. High-income countries built national research councils, cancer research funds, and strong Centres of Excellence, with national funding, because research for evidence-based decision making is a priority. Most African countries do not yet have equivalent structures, but they can.
2. African Centres of Excellence rely heavily on external funding.
Institutions like WASCAL, WACCI, ACEGID, and others are doing outstanding work, but much of their funding still comes from the World Bank, Rockefeller Foundation, BMGF, or European partners. These investments help – but they also mean research priorities can be donor-driven instead of nationally driven. More African-led funding structures are essential.
3. Universities and governments are not yet fully research-ready.
At many African universities, rising student numbers and heavy teaching loads leave little room for research careers. One can remain in post by teaching alone.
Meanwhile, policymakers rarely consult evidence before making decisions – and researchers too seldom involve policymakers from the start, to make research co-created and its policy recommendations more acceptable. Reviving dedicated research-focused career pathways and building stronger bridges between academia and government would address both problems at once.
But none of these challenges are permanent. Across the continent, change is happening. There is growing recognition – from policymakers, communities, funders, and African scientists – of the value of locally generated evidence.
The recent breast cancer awareness walk in Kumasi, Ghana, organized by Breast Care International and led by Dr Beatrice Wiafe, brought tens of thousands of people (pictured above), illustrating a new desire for research and solutions to address pressing needs like breast cancer in Ghana.
ABCS: science against the odds
The ABCS study is one example of what African teams can achieve when determination meets ingenuity. We are investigating how diet, metabolic health, lifestyle behaviours, and the gut microbiome influence breast cancer risk in African women – a pioneering effort in a region where such studies are extremely rare.
This would not have been possible without a structure: the International Union of Nutrition Sciences (IUNS) taskforce, International Collaboration on Cancers in Relation to Nutrition’s (ICONIC) and the Cancer and Nutrition for Africa (CANA).
Here’s what it looks like behind the scenes.
1. Infrastructure hurdles that demand creativity
High-quality biomarker and microbiome research requires cold-chain systems, reliable freezers, and uninterrupted electricity—not guaranteed in some instances. In ABCS study, we are making things work, including:
- Transporting biological samples long distances while maintaining strict temperature control
- Installing multiple power backups (generators, UPS systems, etc.)
- Building molecular lab capacity at KNUST so samples do not need to leave the continent
- Upgrading ordinary rooms into internationally compliant biobanking spaces
Each freezer that stays cold through a blackout is a small triumph.
2. Funding that comes in waves, not streams
Prospective cohorts in high-income countries run for decades with national funding. African teams rely on short donor cycles, which means:
- Recruitment must align with staggered budgets
- Lab work requires careful timing
- Overheads and compliance requirements must be negotiated with multiple institutions
But these challenges have made us more agile, more creative, and more efficient.
3. Ethical and regulatory complexities
In Ghana, one ethical approval cannot cover an entire multi-hospital/site study. Each institution requires its own approval—with fees, administrative steps, and timelines. This slows things down, but harmonisation discussions are underway, and progress is possible.
4. Participant follow-up without formal addresses
One of the key challenges relates to addressing and household identification systems. While some households have formal addresses, these are not always practically useful, as residents may be unable to provide accurate street names or house numbers. These challenges are further compounded by the fact that individuals may be known by different names within their localities, even when they have official names, as well as by frequent relocation and the widespread use of multiple—and often changing—phone numbers. Together, these factors make accurate household location, participant tracking, and follow-up more complex, necessitating the use of alternative and more flexible identification strategies.
So, we are creating and innovating to enable future follow-up of our participants’ successful, including:
- A plan to visit all participants to take GPS mapping of each participant’s home
- Recording all names (official, maiden, local, nickname)
- Using landmarks like markets, churches, and schools
- Collecting several contact numbers, including those of relatives and neighbours
- Building relationships in the community so people guide us to households
We believe this will work—and improve community trust along the way.
5. Building trust and navigating institutions
Some participants worry about blood draws, sample storage, or the purpose of research – so community engagement, local-language communication, and the involvement of women’s groups and health workers are central to what we do.
On the institutional side, African universities operate under strict accountability frameworks which, while important for transparency, can slow fund release considerably. We’ve learned to anticipate delays, build buffer periods, and work closely with administrative teams.
When people – whether community members or university administrators – understand the value of the research, progress follows.
Turning challenges into opportunities
Across Africa, researchers and institutions are transforming obstacles into platforms for scientific leadership. Here are a few inspiring examples.
1. ACEGID (Nigeria): Genomics leadership born from constraint
When Nigeria faced its 2014 Ebola outbreak, the African Centre of Excellence for Genomics of Infectious Diseases responded by rapidly sequencing viral genomes – and hasn’t stopped since. ACEGID produced Africa’s first SARS-CoV-2 genome sequence at the start of the COVID-19 pandemic and has trained more than 2,500 young scientists across 53 African countries.
What began as an emergency response has become a model for continent-wide scientific capacity.
2. WACCI (West Africa): crop improvement for Africa, led by Africa
The West Africa Centre for Crop Improvement has developed climate-resilient crop varieties, trained hundreds of African plant breeders, and attracted global partnerships – all while keeping the research agenda firmly African.
It demonstrates what sustained institutional investment, led from within the continent, can produce.
3. Dr Catherine Nakalembe (Uganda) closing the data gap from above
Dr Nakalembe is redefining food security monitoring by combining satellite imagery, machine learning, and direct farmer knowledge to help governments predict droughts and crop failures before they become humanitarian crises.
Her work is a reminder that African researchers are not just catching up — they are pioneering approaches that the rest of the world is now looking to replicate.
4. WASCAL (West Africa): climate science led from Africa
The West African Science Service Centre on Climate Change and Adapted Land Use (WASCAL), hosted at Kwame Nkrumah University of Science and Technology, is building regional leadership in climate science by training African scientists, advancing climate-resilient research, and fostering strong international partnerships—while keeping its research agenda firmly rooted in African priorities. It demonstrates the impact of sustained, African-led institutional investment in addressing climate and environmental challenges.
Building lasting cancer research capacity
Africa doesn’t just need isolated research projects; it needs enduring scientific systems. That means:
- building modern laboratories that allow samples and data to remain on the continent,
- investing in training and mentorship to expand capacity in bioinformatics, epidemiology, genomics, and related fields.
- strong regulatory and ethics frameworks shaped by African priorities, and
- country-led research agendas that respond directly to Africa’s health, climate, and development needs.
Every major study should leave a legacy: enhanced human capacity and skills, laboratory systems, improved data governance, and a sustained pipeline of African scientific leaders.
Conclusion: the future is ours to build
Yes, research in sub-Saharan Africa comes with challenges. But this is also the most exciting place to innovate, experiment, and redefine what global health science looks like.
What that requires is not just isolated projects but enduring systems – modern laboratories that keep samples and data on the continent, dedicated research career pathways, training and mentorship in bioinformatics, epidemiology and genomics, and regulatory frameworks shaped by African priorities rather than imported ones.
Every major study should leave a legacy: stronger human capacity, better data governance, and a sustained pipeline of African scientific leaders.
Across the continent, researchers are already proving that the brilliance, resilience, and innovation are here. What we need now is sustained belief and investment – from governments, funders, and global partners – to build research where it matters most and bring the world closer to true health data equity.
The ABCS study is one step towards a larger vision: an African Prospective Investigation into Cancers (APIC). The data Africa generates will not just serve African lives. It will change what the world knows about cancer.
Reginald Adjetey Annan is a Professor of Public Health Nutrition and Principal Investigator of the Africa Breast Cancer Screening (ABCS) Study
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Each year, the sound that stays with me isn’t the rhythmic thunder of footsteps. It’s the roar of excitement from strangers, the laughter cutting through exhaustion, and the quiet moments of determination from runners who push themselves for something bigger than a personal best.
Thank you to our runners
To every single person who ran the London Marathon for our charity: thank you. You’ve turned one of the world’s greatest sporting events into a beacon of hope for cancer patients past, present and future.
With cancer cases set to double to 40 million worldwide per year by 2040, your support matters now more than ever.
Turning miles into life-saving research
Because of you, we can continue to investigate how diet, nutrition, weight and physical activity affect your risk of developing cancer and how to recover from it.
The London Marathon is often described as the greatest fundraising event on earth. For our charity, it is also the greatest expression of community. A day when people come together and say, with their feet and their hearts, that lives can and should be saved.
As the CEO at World Cancer Research Fund, I would like to say a thank you for stepping up in the name of prevention. We are honoured to have you on this journey with us.
Get involved today
Did you know? The London Marathon is just one way people from around the world can support our vital work.
From marathons and skydives to Ultra Challenges, there are so many ways to fundraise for life-changing research.
The impact of your support
Recently, we have funded a study which shows how mild exercise can be beneficial for people receiving cancer treatment. Regular exercise also reduces obesity, which is associated with lower cancer risk.
That’s why we are encouraging more of you to sign up to our challenges and support the cancer prevention and survival revolution.
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Coming into my new role as Interim Head of Policy and Public Affairs 1 at World Cancer Research Fund (WCRF) International, I was immediately faced with trying to understand what ultra-processed foods (UPFs) are and how they might, or might not, contribute to cancer risk.
The harms caused by UPFs have been a growing concern in public health, cancer research and nutrition policy over recent years. The increasing number of scientific publications such as Kevin Hall’s 2019 research and the recent Lancet series on UPFs and human health have further amplified and elevated attention to this critical issue. However, to be certain of the risks between UPFs and cancer, there is a need to identify, review and judge the strength of the evidence related to these potential links.
Foods can go through many different types of processing, not all of which are unhealthy. From common practices such as baking homemade bread and pasteurising milk, to commercial and industrial production which breaks foods down and recombines them, often using artificial preservatives and ingredients that aren’t normally found in a kitchen.
In 2010, the NOVA system of food classification was introduced and is now a common tool to categorise foods according to their level of processing:
- Unprocessed and minimally processed foods, containing no added fats, salt, sugar or other additives. Examples include frozen fruit and vegetables, and pasteurised milk.
- Processed culinary ingredients. These are ingredients that aren’t created to be eaten alone and are often used alongside foods in group 1 such as oils, sugars and salt.
- Processed food, where a product from group 2 – like salt, sugar, fat or vinegar – is added to minimally-processed foods. Examples include tinned goods such as lentils and beans, salted nuts and cheese.
- Ultra-processed foods. Many of the foods we consume daily fall into this category: pre-packaged meals (and yes, I have to admit, I am partial to an easy-to-cook ready meal on a Friday night), industrialised bread, sweets, soft drinks and sweetened yoghurt.
Why is this important and what does it mean for health?
Across the world, the average share of UPFs in a person’s diet ranges from 9% in Iran to 60% in the USA2. Recent UK data shows that 57% of the calories British people eat come from UPFs: a figure that rises, worryingly, to 63.5% for children aged 1.5-11 years and 68% for adolescents aged between 12-18 years. Furthermore, there are critical health equity dimensions to the consumption of UPFs, with greater exposure to UPFs often being found among lower-income, marginalised or socially disadvantaged populations.
The increasing consumption of UPFs is a trend that is being seen not just in high-income countries, but also in low- and middle-income countries (LMICs), leading to a double burden of malnutrition, with many LMICs being faced with challenges of both undernutrition and overweight and obesity at the same time3.
Alongside the growing body of evidence suggesting that UPFs are harmful to health, these trends are concerning. Combining the steady increase of UPF production and consumption in both high-income and lower-income countries, the way in which producers of UPFs undermine food systems and dietary patterns (by displacing minimally processed foods and being more affordable than freshly prepared meals), and the impact of UPFs on pollution, greenhouse gas emissions and biodiversity loss, it is abundantly clear that the growing consumption of UPFs requires urgent policy action.
But what is the link between UPFs and cancer?
Well, the honest answer is that, at the moment, we are not entirely sure. The recent Lancet review of available evidence found some indications that an ultra-processed dietary pattern increased risk of a range of chronic diseases, including cancer-related morbidity and mortality. A small number of studies found an association between the consumption of UPFs and increased overall incidence of cancer.
However, to be certain of the risks between UPFs and cancer, there is a need to identify, review and judge the strength of the evidence related to the potential links between UPFs and cancer risk. This includes the evidence related to the biological mechanisms that may be driving these links. It may also be the case that UPFs, in and of themselves, do not increase our risk of cancer directly but increase the risk of things we know do. For example, the Lancet study found a clear association between UPFs and overweight or obesity – and we know that people living with overweight or obesity have an increased risk of at least 13 different types of cancer. We also know that one way to prevent cancer is to avoid processed meat as we highlight in our 10 Cancer Prevention Recommendations.
What have I learned so far?
In my second week in my new role, I was fortunate enough to attend a policy forum on UPFs organised by Imperial College London. The forum set out a clear case for action and highlighted some excellent examples of good practice in national policy implementation to reduce consumption of UPFs. Two things struck me during this forum:
- The scale of the challenge we are facing: from the force of social media algorithms that dramatically increase exposure to UPF marketing practices, to the power large industry holds over food production and manufacturing processes, and the challenges of implementing regulatory policies that tackle rather than exacerbate health inequities.
- That we can do something about it: the UPF Policy Forum also highlighted progress being made to emphasise the contents of food to consumers (such as high amounts of sugar, salt or fat) using front-of-packing labels. These advances, as demonstrated in the Americas, are a WHO Best Buy policy that can improve consumers’ understanding and choices of foods they eat, as well as push food producers to improve the quality of foods they are making.
My third observation, or question, coming out of the UPF Policy Forum, however, was ‘what does this mean for me in my new role at WCRF International?’ I can see that there are some linkages between UPFs and cancer, but these are in no way conclusive. How can I legitimately argue that by reducing consumption of UPFs you can reduce your risk of cancer when there are still so many unanswered questions? And how can I advocate for policy change without robust scientific evidence?
The good news is that this evidence is coming
WCRF International’s Global Cancer Update Programme, CUP Global, has this year included a systematic review of evidence on UPFs and cancer risk. While there is no guarantee that this review will lead to a clear conclusion on the linkages between UPFs and cancer, it will certainly add more evidence to help inform the debate.
With that in mind, I’m looking forward to July when our CUP Global Expert Panel will come together and review the latest evidence on this. So, if you want to keep informed on the links between UPFs and cancer risk, keep watching this space. Or even better, follow us on LinkedIn and sign up to our monthly e-news for the latest updates.
Notes and references:
1 I’ll be covering this role while Kate Oldridge-Turner is on maternity leave.
2 Monteiro C, Louzada M, Steele-Martinez E et al. Ultra-processed foods and human health: the main thesis and evidence. The Lancet, 2025; 406, 266702684.
3 Popkin B, Corvalan C, Grummer-Strawn L Dynamics of the double burden of malnutrition and the changing nutrition reality. The Lancet, 2019; 395, 65-74.
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Research funded by Wereld Kanker Onderzoek Fonds (WKOF), as part of the World Cancer Research Fund International grant programme, has produced evidence strengthening the case that higher alcohol intake increases bowel (colorectal) cancer risk across its different tumour subtypes. It is the largest ever study on that topic.
It is already well known that drinking alcohol increases the risk of bowel cancer, but the mechanisms needed to be better understood.
Now, the researchers led by Dr Christos Chalitsios and Dr Konstantinos Tsilidis at the University of Ioannina (Greece) and Imperial College London (UK) and the University of Ioannina (Greece), working with international consortia, have brought clearer answers to one of the most important long-standing questions. They set out to answer whether when alcohol increases bowel cancer risk, does it do so mainly through particular “molecular pathways” of the disease, or broadly across them all?
Looking across cancer pathways
To investigate this, researchers pooled data from large consortia (GECCO and the Colon Cancer Family Registry), analysing more than 22,000 people (11,826 cases and 10,888 controls).
Because bowel cancers aren’t all the same, the team examined tumour subtypes defined by molecular features. These features included microsatellite instability (MSI), CpG island methylator phenotype (CIMP), and mutations in the BRAF and KRAS genes.
The key finding was that the alcohol–cancer association looked broadly similar across MSI, CIMP, BRAF and KRAS tumour subtypes (and in combined “pathway” groupings).
In other words, the study found no convincing evidence that alcohol preferentially drives one major molecular subtype over another.
Higher intake, higher risk
Among people who drink alcohol, risk increased with higher intake. Each additional 14 g/day (about 1 drink/day) was linked with around a 10% higher colorectal cancer risk, and this pattern was mainly driven by heavier drinking (more than 28 g/day, roughly more than 2 drinks/day).
Genetic analyses further supported a link between higher alcohol consumption and higher overall colorectal cancer risk, and again did not suggest that risk is confined to any single subtype.
What this means for cancer prevention is clear. Heavier drinking appears to increase bowel cancer risk regardless of tumour subtype. Therefore, our recommendation for cancer prevention continues to be to avoid alcohol. If you do drink, cutting down can help reduce your risk, because there is no completely safe level of alcohol intake when it comes to cancer.
Dr Tsilidis explained:
“Alcohol is consistently associated with a range of adverse health outcomes, and contemporary evidence no longer supports the idea that it is “good” for health at any level. Although there are still unknowns in alcohol and health research, alcohol should not be recommended for disease prevention, and people who choose to drink are advised to keep consumption as low as possible.”
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Understanding why some people reach the age of 100 with remarkable functional capacity and greater resistance to age-related diseases, including cancer, is one of the major questions facing biomedical science today.
A new science review, published last week (24 April) in Nature Reviews Immunology, examines why many centenarians – people who live to 100 years old – retain a functional immune system and greater resistance to age-related diseases.
The international study involving researchers from Universidad Europea suggests that many centenarians retain immune characteristics typical of much younger people.
Professor at the Faculty of Medicine, Health and Sport at Universidad Europea, Alejandro Lucía, said:
“The immune systems of many centenarians display characteristics that help explain not only their longer lifespan, but also their greater resistance to age-related diseases.”
Professor Lucía is funded by Wereld Kanker Onderzoek Fonds (WKOF), as part of the World Cancer Research Fund International grant programme. In his view, the reviewed evidence suggests that “extreme longevity is not due to a single mechanism, but rather to a coordinated adaptation of the body that allows key immune functions to be preserved for longer”.
Preserving immune function
The study reviews the available scientific evidence on the immune system of centenarians. Despite their advanced age, many of them show relatively well-preserved immune function and greater resistance to processes linked to immune system ageing and low-grade chronic inflammation. These characteristics are even more pronounced in semi-supercentenarians (people aged 105-109 years old) and supercentenarians (people who reach 110 years old), whose immune profiles may resemble, in some respects, those of much younger adults.
The research team highlights that a review of international studies indicate that cancer incidence and mortality reduce markedly after 90 years old, with rates falling to 0-4% in people over 100.
Among the most significant findings, Professor Lucía’s review highlights reduced activation of inflammatory mechanisms linked to disease development, enhanced cellular recycling, and DNA signatures consistent with better preservation of immune function. It also points to improved immune surveillance, better-preserved gut microbial diversity, and gene expression patterns in circulating immune cells reminiscent of those in younger individuals.
Overall, the findings reinforce the idea that extreme longevity does not depend on a single factor, but rather on a coordinated adaptation of the body that enables it to maintain immune balance and greater resistance to disease.
World Cancer Research Fund International Executive Director of Research and Policy, Dr Giota Mitrou said:
“This unique review paper is providing much needed insight into the immune system of centenarians, particularly as this demographic continues to grow. Cancer is often considered a disease of ageing, but evidence from this population suggests that it does not increase indefinitely, and that cancer incidence begins to decline at a certain age.
Keeping the immune system balanced may be important for helping it work properly and avoid long-term inflammation. More research is needed to better understand how immune function could help improve health as people get older.”
The study highlights that significant questions remain in this novel area of research, such as the need to expand longitudinal studies and to better understand what occurs at the tissue and organ level, beyond the analyses carried out on blood circulating the body.
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More than half of people starting systemic cancer treatment in England had a history of obesity, even though only around one in four were living with obesity when treatment began, according to new research.
The real-world study of more than 79,000 patients across 13 cancer types showed that relying on a single body mass index (BMI) measurement at treatment start may greatly underestimate patients’ lifetime exposure to obesity. For pancreatic cancer, obesity at the start of treatment was only 13.7%, but lifetime obesity prevalence was 55.8%, demonstrating that current weight doesn’t provide a complete picture of someone’s health.
A team of scientists led by Professor Simon Lord analysed past BMI data from digital health records of patients who were receiving systemic treatments, meaning any kinds of treatment where drugs travel through the bloodstream, such as chemotherapy.
Funded by World Cancer Research Fund and led by the University of Oxford, the findings, published recently in the journal ESMO Real World Data and Digital Oncology, provide valuable real-world data on obesity prevalence among people living with cancer.
The results highlight the need to consider lifetime obesity exposure in clinical decision-making and precision care. The results also provide important information about the prevalence of obesity in a real-world group of patients. This is crucial for informing healthcare provision since body weight informs treatment, such as chemotherapy dosing.
World Cancer Research Fund’s International Assistant Director of Research and Policy, Dr Helen Croker, said:
“This research highlights the opportunity to consider patients’ history of obesity alongside their current health when thinking about broader clinical decision-making.
“Our previous research highlighted how a lack of accurate pre-diagnosis body weight measures in studies of people living with and beyond cancer presented limitations for interpreting the role of BMI on outcomes. It is wonderful to see research we have funded addressing key questions where we have been missing data.”
Digging into the data
The study found that on average, including historical BMI raised obesity prevalence from 26.4% to 53.5% and that lifetime obesity prevalence exceeded 50% in every one of the 13 cancer types studied.
Analysis showed that obesity prevalence varied across cancer types. Cancers that commonly present with cachexia or reduced dietary intake showed lower obesity rates at first treatment, including pancreatic, gastroesophageal, bowel, and lung cancer, and non-Hodgkin lymphoma. The results revealed higher obesity rates at treatment start for uterine, breast cancer and malignant melanoma.
Further analysis found that patients aged over 75 had lower obesity prevalence at the start of treatment, while those living in more deprived areas had higher levels of obesity.
Impact and implications
Obesity is a risk factor for 13 cancer types, and global projections suggest that over 2 million cancer cases could be attributable to obesity by 2070. However, the precise role obesity plays in cancer outcomes and treatment response remains unclear.
Associate Professor in Experimental Cancer Therapeutics at the University of Oxford, Professor Simon Lord, said:
“This work highlights the limitations of using a single BMI measurement, which fails to accurately reflect past obesity exposure. How obesity affects cancer prognosis is extremely complex, with both current and previous obesity likely to be important. This paper reveals large differences between current and past BMI in patients receiving systemic therapy, highlighting the importance of considering both measures.
“So, this study provides clear rationale for considering both current and past BMI in clinical decision making and outcomes research. Not doing so risks missing an important part of the clinical picture.”
This research is also significant because body weight is often used as a guide for making decisions around treatment, such as chemotherapy dosing, and this is more complex in patients with obesity. But until now, the scale of this need has been unclear due to limited obesity prevalence data in real-world clinical populations.
Senior Research Fellow at the Department of Oncology at the University of Oxford, Dr Victoria Perletta, said:
“This study underlines the importance of using longitudinal BMI measures to accurately classify obesity exposure in cancer patients receiving systemic therapy. Our work could have implications for clinical decision-making, as understanding a patient’s history of obesity may help build a fuller picture of their health than BMI at treatment start alone. Because body weight can inform chemotherapy dosing, this may also be relevant to more personalised care.
“Future research could explore how lifetime BMI versus BMI at treatment start associates with cancer outcomes to resolve unanswered questions.”
Researchers note that the growing use of weight-loss medications such as GLP-1 receptor agonists may further change obesity patterns in cancer patients, making longitudinal tracking even more important in future studies.
“Although the link between obesity and cancer risk is well established, its impact on cancer outcomes remains uncertain and relying only on BMI at treatment start may miss important lifetime exposure that could influence cancer prognosis,” added Dr Croker.
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Over the last few years, both the mother and father of Kemi Williams died from cancer in their early sixties.
Following this, Kemi herself was diagnosed with a chronic condition which caused severe pain, inflammation, and immobility. She was left sofa bound with extreme weight fluctuations in the space of a year.
“I knew I wanted to respond to my parents’ deaths in a useful way, but I was paralysed with grief and my body was giving up on me. I began suffering from severe exhaustion and extreme pain to the point I could barely move,” Kemi said.
Determined to reclaim her health, Kemi drastically overhauled her nutrition, streamlined her food intake for recovery, and began rebuilding her fitness by going for short walks before incorporating running for one minute or two at a time.
This year, she will run the TCS London Marathon to support life-changing research and give hope to people with cancer.
Reflecting on her journey, Kemi shared:
“In October 2024, I could barely walk. But once the worst of my symptoms passed, I began run-walking. Those tiny, incremental steps were gruelling at the time, but they changed everything.”
By October 2025, significant improvements in her health enabled Kemi to run a half-marathon – a feat which solidified her dedication to using the sport as a cathartic tool for regaining control of her life.
“So many things in life are dependent on someone else being in charge and having control… over our jobs, opportunities, freedom, availability… on a daily basis and with regards to our long-term dreams. But running is the one thing you can take ownership of, it is you taking charge of yourself. It’s been so empowering to regain control of my body – from a place of illness and immobility – and rebuild my entire sense of self,” she said.
Running has been instrumental in helping Kemi cope with her grief as she comes to terms with the loss of her parents.
“I often wake up angry, stressed or feeling quite down. Using those moments to propel my body to run, when my mind might be wrecking havoc or in a state of apathy, and forcing myself into the repeated, rhythmic movement of putting one foot in front of the other somehow has a shake, cleanse, and reset effect. It leaves me recharged for the day ahead, and I can reframe and reflect on the grief that I carry,” she explained.
World Cancer Research Fund CEO, Rachael Hutson, commented:
“We are incredibly inspired by Kemi and her determination to not only improve her own health and wellbeing, but to fund life-changing research that will help people live free from the devastating effects of cancer. Our work would not be possible without the help of generous people like her, and we cannot wait to cheer her on.”
As she prepares for the 26.2-mile route, Kemi says the thought of seeing her two young daughters at the finish line, visualising them both beckoning her forth and cheering her on, is what gives her the mental strength to carry on.
“Near the end of my runs, when I’m tired and everything hurts, I picture my girls and their dad waiting for me at the end of the road. In my mind, I can hear them shouting ‘come on mummy.’ I know they’ll be there at the marathon waiting for me, and it’s the joy of having new life in my daughters that has been pivotal in navigating the end of life for my parents. If I can help give people more time with their loved ones, through the insight and tools they need to engage in the very best health and fitness their bodies can give them, then it’s a challenge worth doing.”
You can show Kemi your support by donating or sharing her story at the link below:
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New research provides a comprehensive analysis of the current evidence on associations between sleep duration, chronotype, insomnia, and snoring, and the risk of reproductive cancers.
A chronotype is an individual’s natural preference for the timing of sleep and wakefulness across the 24-hour day.
A recent study, published in Sleep Medicine Reviews, found that women with an evening chronotype (a preference for later sleep/wake times) were found to have a higher risk of breast and epithelial ovarian cancer, compared to those with a morning chronotype. Led by Dr Christos Chalitsios and Dr Eirini Pagkalidou, and funded by World Cancer Research Fund (WCRF), a team at the University of Ioannina in Greece gathered and analysed data from observational studies on sleep and reproductive cancers.
Overall, the evidence suggests that circadian misalignment – such as staying awake late at night – may be an important sleep-related factor associated with cancer risk, rather than general sleep quality or quantity.
University of Ioannina’s Dr Christos Chalitsios, said:
“This research builds on existing evidence which suggests that a later sleep chronotype may be associated with a higher risk of breast and ovarian cancer. Overall, these findings help clarify how different aspects of sleep may relate to reproductive cancers and further research is needed to better understand the underlying biological mechanisms, and whether modifying sleep behaviours can reduce cancer risk.”
A link between chronotype and breast and epithelial ovarian cancer
Reproductive cancers, which are cancers related to sex hormones or reproductive organs, such as breast, prostate, endometrial and epithelial ovarian cancer, significantly contribute to the global cancer burden. Breast cancer is the most common cancer in women worldwide and prostate cancer is the second most common cancer in men.
Dr Chalitsios and his team carried out a systematic review of 62 observational studies, and a meta-analysis of 61 individual studies from 55 publications, that examined different sleep traits – namely insomnia, sleep chronotype, snoring and sleep duration.
From their analysis, the team found that an evening chronotype (‘night owls’) was associated with a 12% higher risk of breast cancer and a 15% higher risk of epithelial ovarian cancer compared to a morning chronotype (‘morning larks’).
World Cancer Research Fund International’s Assistant Director of Research and Policy, Dr Helen Croker, said:
“While sleep is widely recognised as an important contributor to overall health, its role in cancer risk has remained unclear. These findings provide the first systematic review and meta-analysis evaluating the association between sleep traits and reproductive cancers and help strengthen the evidence that later sleep patterns may be associated with a higher risk of breast and epithelial ovarian cancers.”
No clear evidence for insomnia
However, the team found that the evidence for insomnia and sleep duration was inconsistent. While some analyses initially suggested an increased breast cancer risk with insomnia, this association was not observed in studies that better accounted for potential confounders, pointing to the impact of multiple factors. Although insomnia can be particularly challenging to measure, further research is required to try and better understand this link.
Similarly, no clear relationship was observed between sleep duration and reproductive cancer risk, with different findings across studies and no convincing dose-response pattern, suggesting that the amount of sleep people get each day is unlikely to be an independent risk factor.
Dr Chalitsios said:
“There was no consistent or convincing evidence linking sleep duration, insomnia or snoring, with cancer risk. Although some analyses suggested a higher risk of breast cancer for people with insomnia, particularly for clinically diagnosed insomnia, the association wasn’tseen in studies that more fully adjusted for potential confounders.”
These findings support the hypothesis that circadian disruption may play a role in cancer development and are consistent with existing theories on the carcinogenic effects of light at night, as well as evidence of increased cancer risk among night shift workers exposed to artificial light at night.
Dr Croker added:
“We are delighted to see WCRF International’s INSPIRE Research Challenge grants supporting early career researchers to generate valuable insights into emerging areas of cancer research, with the potential to inform future recommendations on healthy sleep habits.”
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Courtney Bundrick will run for World Cancer Research Fund on 26 April 2026 to support cancer prevention research following the deaths of her parents.
The internal medicine physician, from Little Rock, is fundraising in memory of her mother – who died from ovarian cancer when Courtney was just 12 years old.
Courtney’s role caring for people with advanced cancer was also inspired by her father, who was a physician before passing away in 2023.
This frontline healthcare experience motivated Courtney to take action beyond hospital walls. By fundraising for cancer prevention research, she hopes to improve outcomes for future patients.
“Most of the cancer patients I see are either newly diagnosed with severe symptoms or suffering from advanced disease,” Courtney explained. “By that point, treatment options can be limited. That’s why I’m passionate about fundraising for life-changing cancer research.”
For Courtney, running has been a healthy release since medical school, and she has embraced discipline and mental resilience ever since.
“Training for a marathon takes months of commitment, but I love the structure and focus it gives me. It’s also a healthier way to manage stress, especially after starting my career during the pandemic.”
This dedication has not gone unnoticed by her patients, who are touched by Courtney’s efforts.
“Sometimes I’ll come into work after training, which often sparks conversations,” she shared. “Some of my patients were runners themselves, so it becomes a way for us to connect.”
World Cancer Research Fund CEO, Rachael Hutson, said:
“Every day, we see the impact that cancer has on people, families, and communities. It’s people like Courtney, who bring both professional experience and personal insight, that inspire change. By running the London Marathon, she’s driving forward life-changing research into how diet, nutrition, and physical activity can reduce cancer risk and improve survival. We’re grateful for her dedication and are incredibly proud to have her on the team.”
As she prepares for London, Courtney carries the memory of her mother and the stories of the patients she cares for every day.
“I’m doing this for them,” she said. “Anything we can do to advance research and prevent others from reaching the late stages, that’s what matters most.”
You can show Courtney your support by donating or sharing her story at the link below.
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Endorsement overview
The Continuing Professional Development (CPD) endorsement confirms the workshop meets high standards for evidence-based practice. It supports nutritionists and health professionals to maintain and build their knowledge and skills.
About the workshop
This 90-minute interactive workshop is based on evidence from our Third Expert Report on Diet, Nutrition, Physical Activity and Cancer. It turns research on cancer risk into practical, patient-centred guidance for health professionals to deliver to their communities.
The session covers key cancer risk factors including diet, physical activity, body weight, and alcohol. It also introduces WCRF’s 10 Cancer Prevention Recommendations.
Participants build confidence in discussing cancer prevention with patients and clients. The workshop explores common barriers and applies behaviour change techniques to support healthier habits.
Why it matters
Cancer prevention is a growing priority across healthcare systems as part of the NHS Long Term Plan. This endorsement highlights our role as a trusted provider of high-quality, accessible, and evidence-based training.
What the endorsement recognises
The Association of Nutrition highlighted that the workshop provides clear, relevant learning outcomes for nutrition professionals. It offers strong, evidence-based insights into how diet, nutrition, body weight, and physical activity affect cancer risk.
The live online format allows direct interaction with course leaders, while flexible delivery dates improve accessibility. Overall, it is a well-structured and valuable resource for continuing professional development.
Isobel Booth, Head of Health Information at World Cancer Research Fund, said:
In a time when misinformation about health and nutrition is widespread, it’s important that health professionals have access to credible, evidence-based information. Our workshops are grounded in robust scientific evidence and aim to support health professionals to have confident, practical conversations with patients about cancer prevention.
To find out more about the workshop and other resources, visit:
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Riccardo Pilloni will take on the iconic event 22 years after his diagnosis and eight years after his father, Edmondo, died from liver cancer.
When Riccardo was 19 years old, he found a lump on his collarbone. He visited his GP and was told his symptoms could be seasonal flu related.
After his mother insisted that the doctor investigate further, Riccardo was referred to a haematologist. There, a biopsy revealed that this swollen lymph node was Hodgkin lymphoma – a type of blood cancer that begins in white blood cells.
“I remember feeling really healthy at the time, so the diagnosis was a huge shock,” Riccardo explained. “It felt like the rug has been pulled from under me.”
His treatment included chemotherapy followed by radiotherapy.
“When I looked in the mirror during treatment, I didn’t recognise myself. It destroys your body,” Riccardo shared.
Despite the long-term and late effects of his treatment, Riccardo considers himself “one of the lucky ones” having received an early diagnosis which meant his cancer had not spread. After months of treatment, he made a full recovery.
When his father was diagnosed with cancer years later, Riccardo felt a sense of helplessness as he watched him begin his own cancer journey.
“When I was fighting cancer, it was easier in a way because it was my own personal battle. But when it was happening to my dad, I felt powerless.”
After his father’s death, Riccardo became committed to supporting cancer prevention research and began his London Marathon training.
“Looking at how we can stop cancer before it starts feels like real progress. Trying to solve a problem like cancer before it begins, rather than treating it later, can save lives,” he added.
Riccardo says that grief and survival have shaped his outlook on life in equal measure.
“There is no finish line with grief, it stays with you forever. But when you’re going through cancer yourself, the finish line is going back to normal life,” he explained. “In both cases, you can’t see the finish line and you have to put the effort into moving forward.”
Running 26.2-miles through London is a personal commitment to honouring his dad’s memory and offering hope to others.
“I want people going through cancer to know that you’re not alone in this and there’s a beautiful life after.”
World Cancer Research Fund’s CEO, Rachael Hutson, said:
“We are incredibly grateful to Riccardo for turning such personal challenges into something positive. His experience, from a cancer diagnosis at such young age to the loss of his father, is the reality faced by so many families and shows why our work is so important. We will be cheering him on every step of the way.”
Now more than two decades in remission, Riccardo reflects both on the treatment that saved his life and the people behind it.
“I’m incredibly grateful to have survived and forever indebted to the healthcare professionals who treated me… and people I haven’t met too. Chemotherapy was developed and refined thanks to the tireless efforts of many scientists and I’m here today because of them.”
This gratitude is the driving force behind his fundraising efforts for World Cancer Research Fund.
“Now I’m focused on helping others. I’m taking on the London Marathon to help people diagnosed today who may not be as lucky as I was.”
You can show Riccardo your support by visiting the link below:
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Marta Mixa is running the iconic TCS London Marathon for World Cancer Research Fund – earning all six stars from the original Abbot World Marathon Majors series (the world’s most prestigious long-distance running events).
Born in San Salvador and a US citizen for 40 years, Marta began her six-star journey back in 2019 with the New York City Marathon. After qualifying Boston and Chicago and running Berlin in the same year, Marta went on to complete three World Marathon Majors in 2022 alone.
In 2024, she crossed the finish line once more, completing the Tokyo Marathon and bringing herself one step closer to the iconic medal. Now more determined than ever to conquer the programme, Marta registered for the TCS London Marathon in a bid to earn her sixth and final star.
Fundraising for cancer prevention research is important to Marta after losing her aunt to breast cancer in 2024.
“She fought until the very end, but cancer stole her life, leaving three children, grandchildren, and her great grandchildren behind”, Marta shared. “It was really hard because she was the first family member that ever passed away from cancer.”
Marta’s sister-in-law, Sue, was also diagnosed with cancer in another devastating blow for the family.
“Sue was a vivacious, strong woman who loved the great outdoors and lit up every room. She fought for six long years and it was hard to see her go.”
Driven by her loss, Marta committed herself to not only support cancer research but to embracing a healthier lifestyle – which is proven by science to reduce risk of cancer along with many other conditions.
Marta’s love of running began in her late thirties, and over the past six years, she has completed 15 marathons. She credits her strength and endurance in her sixties to a balanced, nutrient-rich diet.
“The right protein is so important, together with carbohydrates. Carbs give you energy, and protein keeps you strong. I try to incorporate lots of fruit and vegetables into my diet, as well as lean protein such as salmon and chicken”, Marta explained.
World Cancer Research Fund’s UK Director, Steve Greenberg, commented:
“Marta is an unstoppable force, and her dedication to funding life-changing research is truly inspirational. Her active lifestyle and balanced diet echos our Cancer Prevention Recommendations, which help people live longer, healthier, and happier lives free from the devastating effects of cancer. She embodies everything that World Cancer Research Fund is about, and we are truly grateful for her support.”
For Marta, the journey has always been about more than medals.
“My motivation is letting others know they can do it too. Your age doesn’t matter”, she explained. “Stay strong, stay fit, stay healthy. Your body will thank you for it.”
You can show Marta your support by donating or sharing her story at the link below: