Diet, Physical Activity, Weight & Cancer Survivorship: Perspectives from the NCI

Transcription

1 Diet, Physical Activity, Weight & Cancer Survivorship: Perspectives from the NCI American Institute for Cancer Research Meeting October 21, 2010 Catherine M. Alfano, Ph.D. Program Director & Behavioral Scientist Office of Cancer Survivorship, DCCPS National Cancer Institute

2 Estimated Number of Cancer Survivors in the United States From 1971 to ,000,000 10,000,000 8,000,000 Number 6,000,000 4,000,000 2,000,000 0 Year Data source: Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, Ruhl J, Howlader N, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Cronin K, Chen HS, Feuer EJ, Stinchcomb DG, Edwards BK (eds). SEER Cancer Statistics Review, , National Cancer Institute. Bethesda, MD, based on November 2009 SEER data submission, posted to the SEER web site, 2010.

3 Estimated Number of Persons Alive in the U.S. Diagnosed with Cancer on January 1, 2007 by Site (N = 11.7 M) Thyroid 4% Other 15% Female Breast 22% Melanoma 7% Urinary Tract (Bladder, Kidney, Renal Pelvis) 7% Prostate 19% Hematologic (HD,NHL,Leukemia, ALL, Myeloma) 8% Gynecologic 9% Colorectal 9% Data source: Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, Ruhl J, Howlader N, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Cronin K, Chen HS, Feuer EJ, Stinchcomb DG, Edwards BK (eds). SEER Cancer Statistics Review, , National Cancer Institute. Bethesda, MD, based on November 2009 SEER data submission, posted to the SEER web site, 2010.

4 Estimated Number of Persons Alive in the U.S. Diagnosed with Cancer on January 1, 2007 by Time From Diagnosis and Gender (Invasive/1st Primary Cases Only, N = 11.7 M survivors) 2.5 People in millions Males Females 0 to <5 5 to <10 10 to <15 15 to <20 20 to <25 25 Years from Diagnosis Data source: Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, Ruhl J, Howlader N, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Cronin K, Chen HS, Feuer EJ, Stinchcomb DG, Edwards BK (eds). SEER Cancer Statistics Review, , National Cancer Institute. Bethesda, MD, based on November 2009 SEER data submission, posted to the SEER web site, 2010.

5 Estimated Number of Persons Alive in the U.S. Diagnosed with Cancer on January 1, 2007 by Current Age (Invasive/1st Primary Cases Only, N = 11.7 M survivors) 0-19 Years 1% Years 2% Years 4% Years 8% 70+ Years 50% Years 16% Years 22% Data source: Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, Ruhl J, Howlader N, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Cronin K, Chen HS, Feuer EJ, Stinchcomb DG, Edwards BK (eds). SEER Cancer Statistics Review, , National Cancer Institute. Bethesda, MD, based on November 2009 SEER data submission, posted to the SEER web site, 2010.

6 Office of Cancer Survivorship Goals The ultimate goal of the OCS is to enhance the length and quality of survival of all cancer survivors To provide a focus for the support of research that will lead to a clearer understanding of, and the ultimate prevention of, or reduction in, adverse physical, psychosocial, and economic outcomes associated with cancer and its treatment. To educate professionals who deal with cancer survivors about issues and practices critical to the optimal well-being of their patients. This educational commitment extends to cancer survivors and their families.

7 NIH Survivorship Research Grants in FY2007 by Survivor Population Studied (N = 277) (*Grants may have more than 1 focus)

8 NIH Survivorship Research Grants in FY2007 by Late/Long-Term Effect (N = 277) (* Grants may have more than 1 focus)

9 Why the research interest in diet, PA, weight among cancer survivors? Energy balance factors may influence numerous, diverse survivorship outcomes including survival

10 Growth in NIH-funded Grants Focusing on Diet, PA, Weight and Survivorship

11 Diet, PA, Weight & Survivorship: Current Grant Targets Long-term/Late effects of cancer treatment Physical, Psychological, Social, Existential Disease recurrence/new cancers Comorbid conditions (CVD, endocrine, osteoporosis) Obesity/adverse body composition Functional decline & disability Poor QOL

12 Trends in Diet, PA, Weight and Survivorship Research Design Early Studies Generally descriptive Single-site; Small samples Outcomes: QOL, no focus on mechanisms Uni-disciplinary Intervention not chosen based on outcome Conducted largely among breast cancer survivors Next Generation Studies More RCTs Multi-site, large samples Test biobehavioral mechanisms of intervention Multidisciplinary teams required Intervention and outcome carefully chosen Diverse samples Long-term follow-up

13 Diet, PA, & Weight: The Survivor Perspective Survivors want to reduce the morbidity & mortality associated with their illness Survivors want to work with their healthcare providers to address these Frustrated at perception that there is little to offer them Survivors are asking how to be an active participant in optimizing their future health Cancer may be a teachable moment for health behavior interventions

14 Thank you!