Obesity is a major public health issue in the United States, and the rates have risen dramatically since 1990.1 In many states, 36.5% of adults and 17.0% of children and adolescents are obese.2 Obesity contributes to major noncommunicable diseases including cardiovascular disease, diabetes, and cancer, both in terms of risk and mortality. As many as 84,000 cancer diagnoses each year are attributed to obesity, and overweight and obesity are implicated in 15% to 20% of total cancer-related mortality.3
Obesity is also associated with a worse prognosis after a cancer diagnosis and may negatively affect the delivery of systemic therapy, contribute to the morbidity of cancer treatment, and raise the risk of second malignancies and comorbidities.3
ASCO has been raising awareness of the connections between obesity and cancer risk and outcomes since 2013 when the Energy Balance Work Group was developed to evaluate the evidence and generate recommendations for the role ASCO should take in these areas. Despite the strong connections between obesity and both cancer risk and cancer outcomes, most Americans are unaware that obesity will increase their risk of developing or dying from cancer.
Dr. Jennifer Ligibel
Dr. Clifford Hudis
“When we started this effort, the goals were to make the oncology community more aware of the connection between obesity, inactivity, and cancer risk, and find ways to help providers talk to patients about this,” Jennifer A. Ligibel, MD, of the Dana-Farber Cancer Institute, said. “The research shows that when people are diagnosed with cancer, they are more open to changing their lifestyle and losing weight, which makes this a teachable moment.”
“There was growing evidence from basic and translational science that obesity was a contributing factor to various cancers,” ASCO Chief Executive Officer Clifford A. Hudis, MD, FACP, FASCO, said.
This motivated ASCO’s Board of Directors in 2013 to “elevate the issue of obesity strategically and put ASCO resources to work in addressing it,” Dr. Hudis said. The board’s strategic obesity initiative focused on raising public awareness, research, policy, and advocacy.
In October 2017, as a result of the continued need for ASCO’s involvement in obesity awareness and prevention, the temporary Energy Balance Work Group became the Obesity and Energy Balance Subcommittee, a permanent branch of the Cancer Prevention Committee. Dr. Ligibel, who chairs the subcommittee, told the ASCO Daily News that the subcommittee met in December 2017 to “consider where ASCO should focus its efforts in this area, and how ASCO’s unique role representing oncology professionals could have the biggest influence in reducing the impact of obesity on cancer risk and outcomes.”
The Obesity and Energy Balance Subcommittee developed plans for a number of new initiatives over the next few years, including:
- A survey of ASCO members to determine whether they are discussing physical activity and weight management with patients during and after cancer treatment, and to identify tools and resources that could help support oncology providers in these discussions;
- Development of guidelines that would incorporate physical activity, weight management, and dietary intake at different points during the cancer trajectory; and
- Development of initiatives to educate oncology professionals at all career stages about the relationship between obesity and cancer, as well as strategies to help patients lose weight and make other lifestyle changes during and after treatment.
ASCO’s Previous Obesity Efforts
ASCO’s new initiatives to combat obesity build upon an already robust effort by the Society. For example, in recognition that a broad-based collaboration needed to tackle this public health crisis, ASCO hosted the Summit on Addressing Obesity Through Multidisciplinary Collaboration in 2016. “We brought different professional organizations together that have been working in this area to look at where we can synergize and harmonize our efforts. We realized that by coordinating our efforts, we could avoid duplication, reach a broader audience, and have more of
an impact than working on our own,” Dr. Ligibel said.
an impact than working on our own,” Dr. Ligibel said.
The subcommittee’s efforts were in addition to the resources and events developed by the original Energy Balance Work Group in 2014, including:
- ASCO’s “Position Statement on Obesity and Cancer,” published in the Journal of Clinical Oncology (JCO). The statement outlines ASCO’s interest in obesity and cancer, its priorities, and its initiatives to increase awareness of the links between obesity and cancer.3
- The Obesity Toolkit, designed to educate oncologists and patients about the role weight management and healthy lifestyle behaviors play in cancer. The toolkit was updated in 2015 and has been translated into Spanish and French. For more information, visit asco.org/obesity.
- ASCO’s Research Summit on Advancing Obesity Clinical Trials in Cancer Survivors, held in 2014 to identify the unmet needs and opportunities for research regarding obesity, weight loss, and cancer. “Most of the research studies up to this point have been observational. We looked at what types of additional data will be needed to establish weight loss and physical activity as a standard part of cancer care,” Dr. Ligibel said. The recommendations from the summit were published in JCO in November 2015.4
“ASCO has recognized that obesity is an area of increasing research. Having high-quality research will enable us to determine what policies we should advocate for on behalf of our patients with cancer and enable oncology providers to give patients evidence-based information to make the necessary lifestyle changes to reduce obesity,” Dr. Ligibel said.
–Christine Lehmann, MA
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.