Introduction to the WCRF International Continuous Update Project By Dr Rachel Thompson, Head of Research Interpretation/ Head CUP Secretariat 6 December 2014, UICC World Cancer Congress, Melbourne

1. Introduction to the WCRF International
Continuous Update Project
Dr Rachel Thompson
Head of Research Interpretation/ Head CUP Secretariat
6 December 2014, UICC World Cancer Congress, Melbourne

2. Underlying principles

Exposures include diet, nutrition and physical activity

Cancers with some evidence of link with above

Identify causal exposures - protective or adverse

Use most robust methods for systematically reviewing
evidence on epidemiology

Epidemiological evidence of a link needs to be supported by
biological mechanisms

Transparency

3. Protocol
(peer
review)
4 Mar 2011
Search for
papers &
add to
database
Analyses &
prepare
report (peer
review)
5 Dec 2012
Draft
discussion
paper and
call with
Panel leads
3 April 2013
Panel
meeting
decisions
25 June
2013
CUP Report
(signed off
by Panel)
PUBLISH
4 Sept 2013
Imperial College London Secretariat Panel Secretariat

4. Grading criteria
Predefined requirements for

Number and types of studies

Quality of exposure and outcome assessment

Heterogeneity within and between study types

Exclusion of chance, bias or confounding

Biological gradient

Evidence of mechanisms

Size of effect

5. Grading the evidence
Decreases risk Increases risk
Strong evidence Convincing
Probable
Limited
evidence
Limited -
suggestive
Limited – no
conclusion
Strong evidence Substantial
effect on risk
unlikely
Basis for recommendations

6. Changes to conclusions for strong evidence since 2007
(except prostate cancer)
Change Exposure Cancer From To
Stronger Foods containing
fibre
Colorectum Probable
decreased
Convincing
decreased
New conclusion Coffee Endometrium No conclusion Probable
decreased
New conclusion Glycaemic load Endometrium No conclusion Probable
increased
New conclusion Body fatness Ovary No conclusion Probable
increased
No conclusion Foods containing
folate
Pancreas Probable
decreased
No conclusion

7. Summary
of strong
evidence
on diet,
nutrition,
physical
activity
and
cancer

8. Mechanisms

Second Expert Report – mechanisms in the form of narrative
reviews (not systematic reviews)

No existing systematic method similar to that followed for
epidemiological studies for the Continuous Update Project

Advisory group led by Steve Hursting identified concepts and
initial work

Working with University of Bristol to develop methodology for
systematically reviewing mechanistic studies (human/animal/cell
lines)

9. Publications timetable
Year Publication
2010 Breast
2011 Colorectum
2012 Pancreas
2013-14 Endometrium, ovary, breast cancer survivors, prostate
2015 Liver, bladder, kidney, gallbladder
2015-16 Stomach, oesophagus, lung
2016-17 Mouth, pharynx, larynx, nasopharynx, breast, colorectum
2017 Review Recommendations for Cancer Prevention

10. For further information
Rachel Thompson
Head of Research Interpretation
r.thompson@wcrf.org
@wcrfint
facebook.com/wcrfint
www.wcrf.org