The World Cancer Research Fund network’s flagship international research programme analyses how diet, nutrition and physical activity affect cancer risk and survival.
This research programme has built up the largest global cancer prevention database in the world, housed at Imperial College, London. It’s the only authoritative scientific resource of its kind, trusted by oncology experts, researchers and health professionals worldwide, and evaluated by an independent panel of leading cancer experts.
The programme contains nearly 10,000 papers on cancer prevention and survival, with contributions from over 140 scientists in more than 17 different countries.
The findings from the programme are then used to update our Cancer Prevention Recommendations, which ensures that everyone – from policymakers to members of the public – has access to the most up-to-date information on how to minimise the risk of developing cancer.
The Global Cancer Update Programme was originally established as the Continuous Update Project (CUP) to answer the critical question of how diet, nutrition and physical activity impact cancer risk.
The CUP was behind the development of our groundbreaking First and Second Expert Reports – published in 1997 and 2007 respectively – which were the first ever comprehensive analyses of the research on diet, nutrition, physical activity and cancer. They identified many specific foods (such as processed meat) and elements of the human diet (such as alcohol) that increase or decrease the risk of one or more cancer types.
World Cancer Research Fund International has continued to collect, analyse and judge the global evidence on how diet, nutrition and physical activity are linked to cancer via this major research programme. This culminated in the Third Expert Report and the Cancer Prevention Recommendations, which were updated in May 2018.
Over the last three decades the science on how diet, nutrition and physical activity affect the risk of cancer has evolved. This means we’re constantly addressing the new challenges in cancer prevention and survival research.
As the science has evolved, and our understanding of cancer itself has improved, it’s important to consider how to adapt our research programme to address the future challenges in cancer prevention and survival.
New ways of studying the evidence and exploring the risk factors that may influence cancer are in constant development – World Cancer Research Fund International intends to stay at the forefront of this research.
In 2020–21, experts assessed every aspect of the existing programme. Their aim was to identify and prioritise the most compelling research topics for the next phase.
This transition period also enabled us to review:
In moving to a new approach, World Cancer Research Fund International has identified four key areas of research focus:
Reviewing both diet, nutrition, physical activity and cancer incidence will continue to be a core element of the work. But rather than reviewing all exposures for every cancer, we’ll focus on a systematic scan of the evidence.
This will help us to identify which topics are likely to be fruitful areas of detailed study. In addition, the reviews will be more nuanced, with outcomes examined by cancer subtype rather than considering each cancer as a single disease.
There will also be several collaborative projects to expand the work into new areas, including the impact of different dietary and lifestyle patterns and of diet, nutrition and physical activity exposures over the life course.
We want to focus on the impact of diet, nutrition and physical activity on long-term health after a cancer diagnosis. This will begin with a series of reviews for breast cancer, and reviews on colorectal cancer and prostate cancer will follow.
There will also be specific reviews to determine the impact of diet, nutrition and physical activity on children from cancer diagnosis and into adult life. The first review will be on paediatric acute leukaemia.
We aim to develop a clearer understanding of the biological processes that underpin associations between diet, nutrition, physical activity and cancer.
This will be done by reviewing both human and experimental data and will support both the cancer incidence and cancer survivor reviews.
Obesity was identified as a key risk factor for cancer in the Third Expert Report, increasing the risk of several cancers. This work aims to ensure that our Cancer Prevention Recommendations relating to obesity remain up to date, with the potential to develop more specific recommendations.
The majority of epidemiological studies are conducted in high-income countries such as the UK, the US and Australia. There is limited or no data from some countries, especially low- and middle-income countries.
Most of the evidence has been based on studies conducted in populations of European ancestry and some in Asian populations. However, there is a need for research comparing associations by ethnicity and by genetic ancestry.
Patterns of cancer incidence and prevalence vary considerably according to geographical region. Furthermore, some strong evidence for particular exposures and cancers is relevant only to specific geographic regions, such as the relationship between liver cancer and exposure to aflatoxins in parts of Africa and Asia.
Both observations make the case for future studies to address the lack of data from low and middle-income countries.
With input from an expert panel, this flagship research programme will generate the best possible answers to the most important questions related to how diet, nutrition and physical activity affect risk of, and survival from, cancer.
The goal is that these answers will benefit the public, the scientific community and the World Cancer Research Fund network.