The CUP Transition: what is it?

Our work so far

Over the last ten years, WCRF has collected, analysed and judged the global evidence on how diet, nutrition and physical activity are linked to cancer through its groundbreaking Continuous Update Project (CUP). This culminated in the Third Expert Report and the Cancer Prevention Recommendations, which were updated in 2018. This currently represents the best evidence available on cancer prevention and survival through diet, nutrition (including body fatness) and physical activity.

The science is evolving

During this time, science has moved forward. There are new ways to study the evidence, new ways of thinking about the risk factors that may influence cancer, and our understanding of cancer itself has improved.

As the science has evolved, it is important that we consider how to adapt the CUP to address the future challenges in cancer prevention and survival research.

The consistency of our Cancer Prevention Recommendations since 1997 – across the First, Second and Third Expert Reports – reflects the stability of the global research over three decades. This provides an excellent basis from which the CUP can further evolve.

The CUP Transition is the process we are putting in place to support the evolution of the CUP from what it is now, to what it will be in the future.

The next frontier

The goal of the CUP Transition is to ensure that the new CUP generates the best possible answers to the most important questions related to how diet, nutrition and physical activity affect risk of, and survival from, cancer – benefitting the public, the scientific community, and the WCRF network.

We will do this by:

• Expanding the work we do on cancer survival. This includes:

1. Updating the evidence on the role of diet, nutrition (including body fatness) and physical activity on survival after breast cancer.
2. For the first time, reviewing the evidence on the role of diet, nutrition (including body fatness) and physical activity on survival after colorectal and prostate cancer.

• Identifying new research to add to the CUP, including how to review and incorporate the underlying biological changes that lead to cancer and how diet, nutrition and physical activity across the life course affects cancer risk.
• Avoiding any repetition of work that just confirms what we already know.
• Ensuring the new CUP is as cost effective as possible.

Practicalities and logistics

The CUP Transition process demands time and appropriate expertise. So we have convened a CUP Transition Panel (CUP-TP) which is co-chaired by Prof Ed Giovannucci from the Harvard T H Chan School of Public Health and Prof Ellen Kampman from Wageningen University. This panel of experts has identified nine important areas of focus which are currently under review. These are:

1. Systems approach – creating a framework to better understand the cancer process at multiple levels.
2. Dietary and lifestyle patterns – gaining a better understanding of how patterns of eating and behaviour affect cancer risk.
3. Biological data – digging deeper into key biological mechanisms that underpin the associations we observe.
4. Cancer subtypes – understanding how different factors affect different subtypes of cancer.
5. Life course – understanding how diet, nutrition and physical activity across the whole life span link to cancer.
6. Childhood cancers – outlining how the WCRF network can investigate how diet, nutrition and physical activity affect survival from childhood cancers.
7. Outcomes after a cancer diagnosis – furthering our understanding of nutrition and lifestyle during and after cancer.
8. Evidence search and synthesis process – reviewing the robust process by which we conduct our work. 
9. Physical activity and nutritional determinants of adiposity (PANDA) – furthering our understanding of the evidence for diet, nutrition, and physical activity and risk of excess weight gain, overweight and obesity across the life course.

The CUP Secretariat will then translate the guidance from the CUP-TP into a practical strategy.

Members of the CUP-TP