The CUP Transition: what is it?

Our flagship Continuous Update Project is entering a new transition phase, as we ensure that we keep up with the latest cancer science

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 cancerand 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 eight important areas of focus to be reviewed ahead of our annual meeting in July 2020. 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. 

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

Members of the CUP-TP

 Name and affiliation

 Role in CUP-TP

 Ed Giovannucci

 Associate Professor of Medicine

 Harvard T H Chan School of Public Health


 Ellen Kampman

 Chair Nutrition and Disease

 Wageningen University


 Kostas Tsilidis

 Senior Lecturer in Cancer Epidemiology

 Imperial College London

 Panel member

 Alan Jackson

 Emeritus Professor of Human Nutrition

 University of Southampton

 Panel member

 Marc Gunter

 Section & Group Head Nutritional Epidemiology Group

 International Agency for Research on Cancer

 Panel member

 Steve Clinton

 Professor of Internal Medicine and clinician

 Ohio State University

 Panel member

 Anne McTiernan

 Professor Public Health

 Fred Hutchinson Cancer Research Center

 Panel member

 Elio Riboli

 Professor in Cancer Epidemiology and Prevention

 Imperial College London


 Vivien Lund


 Public representative