Modifiable Cancer Risk Factors Research Articles

Steady-State Delivery and Chemical Modification of Food Nutrients to Improve Cancer Intervention Ability.

Cancer is a crucial global health problem, and prevention is an important strategy to reduce the burden of the disease. Daily diet is the key modifiable risk factor for cancer, and an increasing body of evidence suggests that specific nutrients in foods may have a preventive effect against cancer. This review summarizes the current evidence on the role of nutrients from foods in cancer intervention. It discusses the potential mechanisms of action of various dietary components, including phytochemicals, vitamins, minerals, and fiber. The findings of epidemiological and clinical studies on their association with cancer risk are highlighted. The foods are rich in bioactive compounds such as carotenoids, flavonoids, and ω-3 fatty acids, which have been proven to have anticancer properties. The effects of steady-state delivery and chemical modification of these food's bioactive components on anticancer and intervention are summarized. Future research should focus on identifying the specific bioactive compounds in foods responsible for their intervention effects and exploring the potential synergistic effects of combining different nutrients in foods. Dietary interventions that incorporate multiple nutrients and whole foods may hold promise for reducing the risk of cancer and improving overall health.

Demographic disparities in the limited awareness of alcohol use as a breast cancer risk factor: empirical findings from a cross-sectional study of U.S. women.

Alcohol use is an established yet modifiable risk factor for breast cancer. However, recent research indicates that the vast majority of U.S. women are unaware that alcohol use is a risk factor for breast cancer. There is limited information about the sociodemographic characteristics and alcohol use correlates of awareness of the alcohol use and breast cancer link, and this is critically important for health promotion and intervention efforts. In this study, we assessed prevalence of the awareness of alcohol use as a risk factor for breast cancer among U.S. women and examined sociodemographic and alcohol use correlates of awareness of this link. We conducted a 20-minute online cross-sectional survey, called the ABLE (Alcohol and Breast Cancer Link Awareness) survey, among U.S. women aged 18 years and older (N = 5,027) in the fall of 2021. Survey questions assessed awareness that alcohol use increases breast cancer risk (yes, no, don't know/unsure); past-year alcohol use and harmful drinking via the Alcohol Use Disorders Identification Test (AUDIT); and family, health, and sociodemographic characteristics. We conducted multivariate multinomial regression analysis to identify correlates of awareness that alcohol use increases breast cancer risk. Overall, 24.4% reported that alcohol use increased breast cancer risk, 40.2% reported they were unsure, and 35.4% reported that there was no link between alcohol use and breast cancer. In adjusted analysis, awareness of alcohol use as a breast cancer risk factor, compared to not being aware or unsure, was associated with being younger (18-25 years old), having a college degree, and having alcohol use disorder symptoms. Black women were less likely than white women to report awareness of the alcohol use and breast cancer link. Overall, only a quarter of U.S. women were aware that alcohol use increases breast cancer risk, although 40% expressed uncertainty. Differences in awareness by age, level of education, race and ethnicity and level of alcohol use offer opportunities for tailored prevention interventions, while the overall low level of awareness calls for widespread efforts to increase awareness of the breast cancer risk from alcohol use among U.S. women.

Proportion of cancer cases and deaths attributable to potentially modifiable risk factors in Peru

BackgroundLimited evidence exists on the population attributable fraction (PAF) of cancer cases and deaths in Latin America. In Peru several studies have been published regarding the PAF of various risk factors and their associated diseases. The objective of this study was to estimate the fraction of cancer cases and deaths attributable to potentially modifiable risk factors in Peru in 2018, before the COVID-19 pandemic in the population of 15 years old and older.MethodsAn ecological study was conducted using the prevalence of exposure of the Peruvian population to modifiable risk factors for cancer, the relative risk associated with each factor, and the number of cancer cases and deaths in 2018 as inputs. We used the Parkin formula with a Montecarlo statistical simulation model to calculate the PAF and confidence intervals. The number of new cancer cases and deaths attributed to each risk factor was determined by multiplying the number of cases and deaths in each gender by the PAF of each risk factor.FindingsIn Peru, 38.5% of new cases (34.5% in men and 42% in women) and 43.4% of cancer-related deaths (43.4% in men and 43.4% in women) were attributable to modifiable risk factors. The number of cancers attributable was 25,308 (10,439 in men and 14,869 in women) and the number of deaths attributable to cancer was 14,839 (6,953 in men and 7,886 in women). The predominant modifiable risk factors contributing to the highest number of cases and deaths were HPV infection (4,563 cases, 2,409 deaths), current tobacco use (3,348 cases, 2,180 deaths), and helicobacter pylori infection (2,677 cases, 1,873 deaths). Among the risk factors, oncogenic infections constituted the group with the highest PAF (16.6% for cases, 19.2% for deaths) followed by other unhealthy lifestyle factors (14.2% for cases, 16.7% for deaths), tobacco (7.2% for cases, 7.2% for deaths) and ultraviolet radiation (0.5% for cases, 0.3% for deaths).ConclusionsPrior to the COVID-19 pandemic, 38.5% of cancer cases and 43.4% of cancer-related deaths in Peru were linked to modifiable risk factors in the population of 15 years old and older. Most preventable cancer cases and deaths were related to oncogenic infections, primarily caused by HPV and helicobacter pylori, followed by tobacco and obesity.

Nutrition Knowledge, Attitudes, and Lifestyle Practices That May Lead to Breast Cancer Risk Reduction among Female University Students in Lebanon.

Research has identified both nonmodifiable and modifiable risk factors for breast cancer (BC), with accumulating evidence showing that adopting adequate dietary practices could decrease the risk of this disease. This study aimed to assess nutrition knowledge, attitudes, and lifestyle practices (KAP) that may lead to BC risk reduction among female university students in Lebanon and examine the determinants of their practices. A cross-sectional survey was conducted using a convenience sampling method, comprising 356 (response rate: 71.2%) female students at the American University of Beirut aged 18 to 25 years with no history of BC. Participants completed a pre-tested questionnaire addressing the objectives of the study. The modified Bloom's cut-off of 75% was used to categorize knowledge and practice scores as poor or good and attitudes as negative or positive. Large proportions of students had poor knowledge (68.3%), negative attitudes (65.4%), and poor practices (98.0%) scores. Pursuing a health-related major and having a higher GPA were associated with better knowledge and attitudes while being older and having a lower degree of stress were associated with positive attitudes only. Having a lower body mass index (BMI) was associated with better practice scores. Better knowledge significantly predicted higher intake of fruits and vegetables. Overall knowledge and attitudes were significantly correlated with each other, but neither was significantly correlated with overall practice. These findings underscore the importance of implementing public health programs geared towards improving nutrition KAP that may lead to BC risk reduction.

Risk of prostate cancer with increasing years of night shift work: A two-stage dose-response meta-analysis with duration of night shift work as exposure dose

IntroductionNight shift work could be a modifiable risk factor for prostate cancer. However, the epidemiological evidence is inconsistent. To summarize the existing evidence on this topic, we conducted a two-stage dose-response meta-analysis. MethodsMedical librarians searched PubMed, EMBASE, and the Cochrane Library on December 30, 2022. Seven criteria were used to determine the inclusion of each study in the present analysis. ResultsEleven cohort studies (12 cohort reports; total cases: 9366; and total person-years: 88,238,009) and seven case-control studies (seven case-control reports; total cases: 5593; and total controls: 6876) were included. This study estimated that the risk of prostate cancer increased by 1, 12, 24, and 39% after 1, 10, 20, and 30 years of night shift work exposure, respectively, according to four cohort and five case-control studies. DiscussionSeven inclusion criteria were used to determine which studies were eligible for this analysis. Risk ratios from cohort studies and odds ratios from case-control studies were analyzed separately. However, all odds ratios from the case-control studies were excluded because of a high likelihood of publication bias. Moreover, exposure, measured in years of night shift work, was defined based on the information provided by individual studies. Finally, we utilized a recently reported two-stage dose-response meta-analysis method. This study provides evidence that night shift work contributes to the risk of prostate cancer in a dose-dependent manner.

Abstract 816: Implementation of a community-based multi-component cancer screening intervention supported by a cross-sector community coalition

Abstract It is widely agreed that screening and early detection of cancer saves lives. However, disparities exist in those who received routine screenings and variability in clinic screening protocol. Working with community-based clinics on quality improvement as well as systematically screening all eligible patients can result in increased equity in screening and thus early detection. Be Well Communities™ is MD Anderson’s place-based approach for cancer prevention and control, working with communities to promote wellness and address modifiable risk factors for cancer. The first several years of the initiative in Baytown focused on healthy eating and active living interventions for cancer prevention, over time the community’s trust and appetite increased which allowed for additional and more traditional cancer prevention interventions (e.g., human papilloma virus vaccination, screening). In this project, three evidence-based interventions for cancer screening were implemented in collaboration with Chambers Health, a local FQHC in Baytown, Texas, to work toward addressing the disparities in screening outcomes experienced by community residents. Chambers Health compliance rates have increased since the beginning of the Cancer Screening Navigation program, supported by Be Well Communities. Two full-time patient navigators are supported to facilitate increased screening through patient education, increased clinic compliance and development of standard operating procedures for navigation related operations. In addition, one full-time Outreach Coordinator is supported to engage with patients and provide education on cancer screenings. Compared to 2022, there was a 39% increase in colon cancer screening compliance rates, a 25% increase in cervical cancer screening compliance rates, and a 47% increase in breast cancer screening compliance rates. Compliance refers to any patient who is up-to-date in their cancer screenings. The Be Well Communities team supported Chambers Health through funding, technical assistance, and capacity building. They were then able to provide culturally relevant and high-quality care to enhance community capacity to address low rates of cancer screening in Baytown. Furthermore, Chambers Health has since integrated the patient navigators and Outreach Coordinator into their operational budget, a notable systems change for the organization and demonstration of commitment to the project and continued clinic quality improvement and more so dedication to the patients served. Citation Format: Ruth Rechis, Mayra Aquino, Haley Gardiner, Blanca Puga, Michael T. Walsh. Implementation of a community-based multi-component cancer screening intervention supported by a cross-sector community coalition [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 816.

Modifiable risk factors for thyroid cancer: lifestyle and residence environment.

In recent years, there has been a rapid increase in the prevalence of benign and malignant tumours of the thyroid gland worldwide, positioning it as one of the most prevalent neoplasms within the endocrine system. While the pathogenesis of thyroid tumours is still unclear, an increasing number of studies have found that certain lifestyle and residence environments are associated with their occurrence and development. This article endeavours to elucidate the correlation between lifestyle, residential environment, and the increased prevalence of thyroid cancer in recent years. It specifies the frequency of the lifestyle and outlines the scope of the residential environment. It also endeavours to summarise the main mechanistic pathways of various modifiable risk factors that cause thyroid cancer. Factors that prevent thyroid cancer include smoking and alcohol consumption, quality and regular sleep, consumption of cruciferous vegetables and dairy products, and consistent long-term exercise. Conversely, individuals with specific genetic mutations have an elevated risk of thyroid cancer from prolonged and frequent use of mobile phones. In addition, individuals who work in high-pressure jobs, work night shifts, and live near volcanoes or in environments associated with pesticides have an elevated risk of developing thyroid cancer. The impact of living near a nuclear power plant on thyroid cancer remains inconclusive. Raising awareness of modifiable risk factors for thyroid cancer will help to accurately prevent and control thyroid cancer. It will provide a scientific basis for future research on lifestyles and living environments suitable for people at high risk of thyroid cancer.

Improving adolescents’ dietary behavior through teacher-delivered cancer prevention education: a school-based cluster randomized intervention trial in urban Rajasthan

BackgroundDietary practices are one of the most common modifiable risk factors for cancers. Foods rich in dietary fibers are considered protective, meanwhile fast & junk foods are risk for common cancers. Adolescence period is marked by habit formation and is thus suited for delivering behavioral intervention. Schools offer an optimal setting for planning and executing these interventions to a large number of adolescents.ObjectiveTo assess the effectiveness of a teacher-delivered cancer-prevention education in changing dietary behaviors of school going adolescents.MethodsA cluster randomized trial was conducted in government secondary and senior secondary schools with schools as clusters. A minimum required sample of 1032 students was estimated from 16 schools with 1:1 allocation in intervention and non-intervention groups. Dietary behaviors were recorded as dichotomous variable. The determinants were recorded as per theory of planned behavior framework using Likert-scale. Two teachers from each intervention school were trained to deliver cancer prevention education with focus on role of dietary behavior. Pre-post training assessment of teachers’ knowledge towards common cancers was done using a self-administered questionnaire. Gender adjusted difference-in-difference analysis was done to assess intervention effect on both healthy and unhealthy behaviors.ResultsIn selected schools all students from classes 8 to 10 were approached and a total of 1224 students were enrolled, of whom 1096 completed the study. The study recorded significant improvement in scores of students from intervention group compared to non-intervention group for their attitude, subjective norms, perceived behavioral control and intention towards consuming healthy and avoiding unhealthy foods. The intervention was effective in significantly improving the proportion of students limiting fried/fast/packed food & sugar sweetened beverages (OR:1.51, 95%CI:1.08,2.12,p:0.017), and consuming fruits & vegetables daily (OR:1.55, 95%CI:1.08,2.22, p:0.017) while adjusting effect of gender.ConclusionClassroom-based cancer prevention education delivered through teachers during regular working hours is effective in improving dietary behaviors and its determinants among adolescent students. Thus, we recommend integrating a section focusing on the role of diet in cancer prevention and other lifestyle diseases in the existing school curriculum.Trial RegistrationThe trial was registered under Clinical Trial Registry-India with registration number CTRI/2018/12/016586, dated-10/12/2018.

Hyperthyroidism and the risk of non-thyroid cancer: a Danish register-based long-term follow-up study.

Cancer is the second most common cause of death worldwide. It is currently debated whether thyroid dysfunction is a modifiable cancer risk factor. Our aim was to evaluate the risk of cancer in patients with hyperthyroidism. This is a register-based nationwide cohort study of individuals with a diagnosis of hyperthyroidism. Each hyperthyroid case was matched with four reference individuals according to age and sex. Using Fine and Gray competing risk regression models, we studied the association of hyperthyroidism and subsequent all-cause cancer diagnoses, adjusted for preexisting morbidity. Sub-analyses were stratified for cause of hyperthyroidism (Graves' disease and toxic nodular goiter, age when diagnosed with hyperthyroidism, sex, and cancer localization (lung, prostate, breast, and colorectal cancer)). The cohort consisted of 95,469 patients with hyperthyroidism (followed for a median of 10.9 years (range: 5.2-17.2)), and 364,494 reference individuals (followed for a median of 11.2 years (range: 5.4-17.4)). Hyperthyroidism was associated with increased all-cause cancer risk (sub-distribution hazard ratio (SHR): 1.12; 95% CI: 1.10-1.14), as well as an increased risk of breast (SHR: 1.07; 95% CI: 1.02-1.13), lung (SHR: 1.20; 95% CI: 1.16-1.26), and prostate cancer (SHR: 1.10; 95% CI: 1.02-1.19), but not colorectal cancer (SHR: 1.04; 95% CI: 0.99-1.09). Sub-analyses stratified for age when diagnosed with hyperthyroidism and cause of hyperthyroidism yielded similar results. In this register-based study, patients with hyperthyroidism had an increased risk of cancer, in particular lung, prostate, and breast cancer. Whether a causal link exists remains to be proven.

Effect of telephone‐assisted smoking cessation programme on the self‐efficacy, recurrence in patients with bladder cancer: A study protocol

AbstractThe aim of this study protocol is to examine the effect of telephone‐assisted smoking cessation programme based on the information motivation behavioural skills model on the self‐efficacy, smoking behaviour, tumour recurrence and progression in patients diagnosed with non‐muscle‐invasive bladder cancer. A single‐center, single‐blind, parallel‐group, randomized control trial. The intervention group will receive telephone‐assisted smoking cessation programme, while no intervention will be applied to the control group. Face‐to‐face smoking cessation training will be provided for the information component of the programme, motivational interview will be conducted via WhatsApp for its motivation component. Motivational interviews will be undertaken in total of six sessions organized at two‐week intervals. The patients' chronic disease management self‐efficacy, smoking behaviour will be evaluated at the third, sixth, 12th months. Tumour recurrence, progression will be followed up by cystoscopy at the third, 12th months. This is a randomized controlled study protocol, results are not available at the time of the submission. All results will be reported on the completion of this study. This study protocol, will involve the implementation of comprehensive smoking cessation programme that is much needed for the target population around the world. It is expected that the use of this programme will increase the self‐efficacy of smokers with bladder cancer, decrease their smoking behaviour and amount of smoking, eliminate tumour recurrence. Smoking is the most important, modifiable risk factor for bladder cancer. In this study, it is expected that the implementation of telephone‐assisted smoking cessation programme based on the information–motivation–behavioural skills model will increase self‐efficacy in cancer management and decrease smoking behaviour, tumour recurrence in patients diagnosed with bladder cancer. In the literature, there is no smoking cessation programme based on this model intended for patients diagnosed with bladder cancer.

The global, regional, and national disease burden of breast cancer attributable to tobacco from 1990 to 2019: a global burden of disease study

ObjectiveTobacco has been identified as a significant contributory element to the development of breast cancer. Our objective was to evaluate the spatiotemporal trends of tobacco-related breast cancer at the global, regional, and national scales during 1990–2019.MethodsWe extracted data on mortality, disability adjusted of life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) from the Global Burden of Disease (GBD) study 2019. Estimated annual percentage change (EAPC) was computed to assess the temporal change in ASDR and ASMR.ResultsIn 2019, the deaths and DALYs attributed to tobacco-related breast cancer were estimated to be 35,439 (95% UI: 22,179–48,119) and 1,060,590 (95% UI: 622,550–1,462,580), respectively. These figures accounted for 5.1% and 5.2% of the total burden of breast cancer. ASMR and ASDR increased in low SDI regions, remained stable in low-middle and middle SDI regions and declined in high and high-middle SDI regions. The burden of breast cancer attributable to tobacco varied notably among regions and nations. Oceania, Southern Latin America, and Central Europe were the GBD regions with the highest number of ASMR and DALYs. There was a positive relationship between age-standardized rate and SDI value in 2019 across 204 nations or territories. A negative association was observed between the EAPC in ASMR or ASDR and the human development index (HDI) in 2019 (R = -0.55, p < 0.01 for ASMR; R = -0.56, p < 0.01 for ASDR).ConclusionTobacco is one important and modifiable risk factor for breast cancer. The heterogeneity in both the spatial and temporal distribution can be attributed to factors such as aging, population growth, and SDI. These findings substantiate the necessity of expediting the enforcement of tobacco-free legislation in order to safeguard populations from the detrimental effects of tobacco.

Exploring the associations between adverse childhood experiences (ACEs) and adolescent cancer risk behaviours in the ALSPAC cohort

BackgroundSome modifiable risk factors for cancer originate during adolescence. While there is evidence indicating relationships between adverse childhood experiences and health risk behaviours generally, little is known about how childhood adversity influences the engagement of adolescents in cancer risk behaviours. This study aimed to determine the relationship between adverse childhood experiences and adolescent cancer risk behaviours.MethodsData were collected prospectively from birth to age 18 years on children born to mothers enrolled into the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort study. Multivariable linear regression models assessed relationships of a composite exposure measure comprised of adverse childhood experiences (total number of childhood adversities experienced from early infancy until age 9 years) with multiple cancer risk behaviours. The latter was expressed as a single continuous score for tobacco smoking, alcohol consumption, obesity, unsafe sex, and physical inactivity, at ages 11, 14, 16 and 18 years. Analysis was carried out on the complete case and imputation samples of 1,368 and 7,358 participants respectively.ResultsAll adolescent cancer risk behaviours increased in prevalence as the adolescents grew older, except for obesity. Each additional adverse childhood experience was associated with a 0.25 unit increase in adolescent cancer risk behaviour (95% CI 0.16–0.34; p < 0.001). Individually, parental substance misuse (β 0.64, 95% CI 0.25–1.03, p < 0.001) and parental separation (β 0.56, 95% CI 0.27–0.86, p < 0.001) demonstrated the strongest evidence of association with engagement in adolescent cancer risk behaviour.ConclusionChildhood adversity was associated with a greater degree of engagement in adolescent cancer risk behaviours. This finding demonstrates the need for targeted primary and secondary prevention interventions that reduce engagement across multiple cancer risk behaviours for children and adolescents who have experienced adversity in childhood, such as parental substance misuse and separation, and reduce exposure to adversity.

Every tenth malignant solid tumor attributed to overweight and alcohol consumption: A population-based cohort study

BackgroundRecent studies have shown that some four in ten cancers are attributable to a few key risk factors. The aim of this study was to estimate cohort-based population attributable fractions (PAFs) in Finland for potentially modifiable cancer risk factors. MethodsData from eight health studies including 253,953 subjects with 29,802 incident malignant solid tumors were analysed using Bayesian multivariate regression model with multiplicative risk factor effects. We estimated the effects of smoking, excess body weight, alcohol consumption, physical activity, parity and education on cancer incidence and related PAFs by cancer site, accounting for competing mortality. ResultsPAF for all cancer sites and exposures combined was 34% (95% credible interval 29%−39%) in men and 24% (19%−28%) in women. In men, 23% (21%−27%) and in women 8% (6%−9%) of all cancers were attributed to smoking. PAF related to excess body weight was 4% (2%−6%) in men and 5% (2%−7%) in women, to alcohol 7% (3%−10%) in men and 4% (0%−7%) in women, and to excess body weight and alcohol combined 10% (6%−15%) in men and 9% (4%−13%) in women. ConclusionSmoking was the most important factor contributing to cancer burden in Finnish men and women over the last 40 years. The contribution of excess body weight and alcohol consumption together outweighed the role of smoking in women. As the prevalence of overweight is expected to increase, more efficient public health measures supporting adherence to healthy weight are essential to reduce cancer burden.

Abstract A027: Creating partnerships to deliver community-based interventions for cancer prevention in a historically African American community

Abstract Be Well Communities™ is MD Anderson’s signature place-based approach for cancer prevention and control, working with communities to promote wellness and address modifiable risk factors for cancer. In this project, the planning phase of the Be Well Communities’ model was implemented in Acres Homes, a neighborhood in northwest Houston with more than 57,000 residents. While the changing demographics show increasing numbers of residents of Hispanic descent (43% of the population), Acres Homes still experiences effects of a legacy of Blacks experiencing poverty; more than half of the population of Acres Homes resides in census tracts that are considered areas of persistent poverty. Further, it is a medically underserved area with relatively high rates of unhealthy behaviors, as compared to Healthy People 2030 goals. To work toward addressing the disparities in health outcomes experienced by community residents, a community advisory group (Steering Committee) including residents, non-profit organizations, health care partners, city and county agencies, plus other stakeholders, was convened and aligned through a structured process to develop shared goals, foster multisector collaboration (as measured by a stakeholder survey administered twice), and enhance community capacity to improve health outcomes through development of a Community Action Plan. Clear, achievable goals were developed, multisector collaboration was enhanced, and more than 400 hours of capacity building support led to a Community Action Plan focused on healthy eating and active living, including 15 evidence-based interventions led by 18 organizations. The majority (93%) of the Steering Committee reports that this plan reflects community priorities and will reach the residents most in need. In the first 2 years of implementation nearly 40% of the residents of the community have been reached by programs including more than 5,000 residents participating in physical activity opportunities, classes and over 1000 individuals receiving outreach from a Community Health Worker within the safety-net hospital system to receive access to healthy food access and nutrition education programming. By listening and developing trust, the Be Well Communities team successfully worked with Acres Homes residents and organizations to enhance community capacity to address health inequities in one of Houston’s most historic communities.  Citation Format: Ruth Rechis, Haley Gardiner, Katy Oestman, Stephanie Nutt, Michael T. Walsh Jr.. Creating partnerships to deliver community-based interventions for cancer prevention in a historically African American community [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A027.

Modifiable risk factors for esophageal cancer in endoscopic screening population: A modeling study.

Modifiable risk factors for esophageal cancer in endoscopic screening population: A modeling study.

Be Well™ Acres Homes: a community-driven, evidence-based approach to reduce health inequities through sustained cross-sector partnership

PurposeBe Well Communities™ is MD Anderson’s signature place-based approach for cancer prevention and control, working with communities to promote wellness and address modifiable risk factors for cancer. The purpose of this paper is to describe implementation of the planning phase of the Be Well Communities model in Acres Homes which began in 2019.MethodsA community advisory group (Steering Committee) including residents, non-profit organizations, health care partners, city and county agencies, plus other stakeholders, was convened and aligned through a structured process to develop shared goals, foster multisector collaboration, as measured by a stakeholder survey administered twice, and enhance community capacity to improve health outcomes through development of a Community Action Plan.ResultsClear, achievable goals were developed, multisector collaboration was enhanced, and more than 400 h of capacity building support led to a Community Action Plan initially focused on healthy eating and active living, including 15 evidence-based interventions led by 18 organizations. The majority (93%) of the Steering Committee reports that this plan reflects community priorities and will reach the residents most in need.ConclusionBy listening and developing trust, the Be Well Communities team successfully worked with Acres Homes residents and organizations to enhance community capacity to address health inequities in one of Houston’s most diverse and historic communities.

International burden of cancer deaths and years of life lost from cancer attributable to four major risk factors: a population-based study in Brazil, Russia, India, China, South Africa, the United Kingdom, and United States

We provide a comprehensive view of the impact of alcohol consumption, tobacco smoking, excess body weight, and human papillomavirus (HPV) infection on cancer mortality and years of life lost (YLLs) in Brazil, Russia, India, China, South Africa, the United Kingdom (UK), and United States (US). We collected population attributable fractions of the four risk factors from global population-based studies and applied these to estimates of cancer deaths in 2020 to obtain potentially preventable cancer deaths and their 95% confidence intervals (CIs). Using life tables, we calculated the number and age-standardised rates of YLLs (ASYR). In Brazil, Russia, India, China, South Africa, the UK, and the US in 2020, an estimated 5.9 million (3.3 million-8.6 million) YLLs from cancer were attributable to alcohol consumption, 20.8 million (17.0 million-24.6 million) YLLs to tobacco smoking, 3.1 million (2.4 million-3.8 million) YLLs to excess body weight, and 4.0 million (3.9 million-4.2 million) YLLs to HPV infection. The ASYR from cancer due to alcohol consumption was highest in China (351.4 YLLs per 100,000 population [95% CI 194.5-519.2]) and lowest in the US (113.5 [69.6-157.1]) and India (115.4 [49.7-172.7). For tobacco smoking, China (1159.9 [950.6-1361.8]) had the highest ASYR followed by Russia (996.8 [831.0-1154.5). For excess body weight, Russia and the US had the highest ASYRs (385.1 [280.6-481.2] and 369.4 [299.6-433.6], respectively). The highest ASYR due to HPV infection was in South Africa (457.1 [453.3-462.6]). ASYRs for alcohol consumption and tobacco smoking were higher among men than women, whereas women had higher ASYRs for excess body weight and HPV infection. Our findings demonstrate the importance of cancer control efforts to reduce the burden of cancer death and YLLs due to modifiable cancer risk factors and promote the use of YLLs to summarise disease burden. Cancer Research UK.

Abstract 11600: Association Between Obesity and Risk of Total and Obesity-Related Cancer in Persons With Incident Cardiovascular Disease

Introduction: Cardiovascular disease (CVD) and cancer often occur in the same people, in part due to shared risk factors. In a Global Burden of Disease analysis of cohorts from &gt;180 countries, obesity was a top 3 modifiable risk factor for CVD and cancer. Beyond shared risk factors, CVD pathophysiologies may synergize with obesity to influence carcinogenesis. If so, an excess cancer risk in obese persons with CVD has implications for clinical management. Hypothesis: Obesity is positively associated with obesity-related cancer (ObCa) risk in persons with incident CVD independent of shared risk factors. Methods: We used data from the Atherosclerosis Risk in Communities (ARIC) study, a cohort with 28 years of cancer follow-up. The analytic cohort was 5127 participants with incident CVD among whom 1511 were diagnosed with a first primary cancer. Follow up began at incident CVD diagnosis date after visit 1. Obesity was classified by BMI, waist circumference (WC), and waist-to-hip ratio (WHR) measured by trained technicians. We calculated incidence rate differences (RD) between obesity groups adjusted for age, sex, and center. The obesity-cancer association was estimated using Fine-Gray regression adjusted for shared risk factors, including smoking. Results: In people with CVD, cancer incidence was higher in the obese (BMI: RD=226.6/100,000 person-years) than normal weight group. In people with CVD, obesity was suggestively positively associated with ObCa (Table 1). In females with CVD, obesity was associated with increased ObCa risk. Associations were null in males, including after excluding prostate cancer. Conclusion: In this prospective study, obesity is positively associated with ObCa risk in women with incident CVD independent of shared risk factors. More work is needed to investigate why the association appeared in women only, and to identify possible mechanisms by which CVD pathophysiologies may interact with obesity to produce cancer risk.

Modifiable risk factors for subsequent lethal prostate cancer among men with an initially negative prostate biopsy.

Previously suggested modifiable risk factors for prostate cancer could have resulted from detection bias because diagnosis requires a biopsy. We investigated modifiable risk factors for a subsequent cancer diagnosis among men with an initially negative prostate biopsy. In total, 10,396 participants of the Health Professionals Follow-up Study with an initial negative prostate biopsy after 1994 were followed for incident prostate cancer until 2017. Potential risk factors were based on previous studies in the general population. Outcomes included localised, advanced, and lethal prostate cancer. With 1851 prostate cancer cases (168 lethal) diagnosed over 23 years of follow-up, the 20-year risk of any prostate cancer diagnosis was 18.5% (95% CI: 17.7-19.3). Higher BMI and lower alcohol intake tended to be associated with lower rates of localised disease. Coffee, lycopene intake and statin use tended to be associated with lower rates of lethal prostate cancer. Results for other risk factors were less precise but compatible with and of similar direction as for men in the overall cohort. Risk factors for future prostate cancer among men with a negative biopsy were generally consistent with those for the general population, supporting their validity given reduced detection bias, and could be actionable, if confirmed.

Secondary risk reduction service acceptability amongst Irish breast cancer survivors and clinicians

Abstract Background Many patients (&amp;gt;75%) diagnosed with breast cancer in Ireland today will be cured and are at risk of dying from other cancers and non-communicable diseases. Breast cancer diagnosis provides a pivotal time point for education on modifiable risk factors and engagement with secondary risk reduction services. Our study set out to establish the level of awareness and acceptability of these areas, respectively. Methods A survey was developed for breast cancer survivors and oncology clinicians using previously validated questionnaires; the ‘Mitchelstown Cohort Survey’ and the ‘International Physical Activity Questionnaire'. IBM SPSS software (Version 28.0) was used for data analysis. Results Between September and December 2021, 322 patients and 29 clinicians attending the South Infirmary Victoria and Cork University Hospitals, completed the survey. Over 80% of patients and clinicians were aware of modifiable cancer risk factors. Only 1 in 5 clinicians had training in secondary risk reduction however 90% were willing to refer to services. Education had an impact on the likelihood of patient engagement with weight management, dietary, and exercise education (Pearson chi-squared test; p = 0.009, 0.039, 0.139 respectively). Patients who smoked, had increased alcohol intake, or gained weight since diagnosis were more likely to engage with services (p = &amp;lt;0.001, p = &amp;lt;0.001, p = 0.015 respectively). Patients who made changes to activity levels since diagnosis were more likely to engage with exercise education (p = 0.015). Conclusions This study identified that over 4 in 5 breast cancer survivors and oncology clinicians were aware of the importance of modifiable lifestyle risk factors. While 9 in 10 clinicians were willing to refer to secondary prevention services if available, the likelihood of patient engagement was associated with their at-risk behaviours and education level. Our study highlights the challenges of implementing health promotion programs in this cohort. Key messages • High level of intended engagement with secondary risk reduction services amongst breast cancer survivors and oncology clinicians. • Likelihood of patient engagement was associated with their at-risk behaviours and education level.