The meeting took place on 27 April and was hosted by the Centre for Research into Cancer Prevention and Screening (CRiPS) and the University of Dundee, chaired by Prof Bob Steele (University of Dundee) and Prof Elio Riboli (Imperial College), and aided by Prof Andrew Renehan (University of Manchester).
The starting points for this meeting were bleak; global cancer rates are rising and obesity-related cancers are rising at younger ages. Recent work from the World Health Organization’s (WHO) International Agency for Research on Cancer (IARC) and us here at World Cancer Research Fund shows clear evidence that obesity control offers significant potential for cancer reduction. Highlights from the meeting included Prof Richard Martin providing a very clear account of how evidence from Mendelian Randomisation (MR) complements and expands understanding of the issues. MR also has the potential to guide work on molecular mechanism, interventions and drug repurposing (eg statins).
Prof Annie Anderson (University of Dundee) focused on what is known about intentional weight loss and cancer risk reduction. Drawing on data from bariatric surgery, observational cohorts and perspectives of the public and patients, she clarified that there is now a body of indicative evidence associated with cancer risk reduction and decreased body weight. The bottom line, however, was that without trial data which provides information on level of effect, side-effects and the impact of weight regain, the current observational evidence is not enough to influence current practice guidelines.
Key issues that arose from discussions
Can we realistically consider weight loss trials for primary and or secondary prevention?
How can we best explore causal association and reversibility?
Who should our target population include and exclude?
Can we develop and deliver the ‘right’ intervention?
What is the optimal timing for intervention and length of duration?
What are the most clinically relevant disease outcomes that can be realistically measured?