One of our research goals – and key work areas – in the Global Cancer Update Programme (CUP Global) is cancer mechanisms
Aims: Identifying the biological processes and mechanisms underpinning differences in cancer risk seen in epidemiological studies.
Benefits of approach
Previous CUP work involved identifying mechanisms that underpin associations seen in epidemiology, but not in a systematic way. Systematic synthesis of mechanistic evidence is enormously challenging due to the nature and breadth of the evidence.
However, it’s also critically important for the strength of our cancer recommendations that we develop better ways of identifying cancer causing or preventing biological mechanisms.
The biological processes workstream developed a prioritisation process and a framework for collating mechanistic evidence, allowing more precise targeting of future mechanistic work. We will then test and further develop this process and framework as part of the new CUP Global work, and will integrate and apply them more widely, both within CUP Global and beyond.
There are two elements of the mechanisms work in CUP Global:
Mechanistic evidence will be developed to support the cancer incidence and survivors reviews during the first three years as follows:
This mechanistic work will be done in parallel with the epidemiology work outlined above.
Providing evidence that there are mechanisms which underpin an association between a risk factor (related to diet, nutrition, physical activity and body weight) and a cancer outcome supports the inference of causality – that the risk factor directly contributes to the outcome occurring.
Within CUP Global, in order for a strong evidence conclusion to be drawn, there needs to be strong and plausible evidence (from either human or animal studies or a combination of the two) of underlying mechanisms that suggest biological plausibility. We can then use this evidence to support and strengthen the development of cancer prevention recommendations.
For both elements of the mechanistic work, The International Agency for Research on Cancer (IARC) is leading the evaluation of mechanistic data (comprising molecular epidemiology studies, genetic and experimental data) using the framework developed by the biological processes workstream.
Dr Marc Gunter is serving as the focal point, working in conjunction with IARC Monographs, where necessary consulting with the IARC expert committee on mechanisms to assist in the evaluations.
The mechanisms work will be conducted in close collaboration with the Imperial College London CUP Global team and will draw on some of their procedures for meta-analyses of epidemiological data.