Abstract PL02-02: Energy balance and cancer prevention: Lessons learned from clinical research
Bibliographic record
Abstract
Abstract Energy balance is associated with risk of development of many common cancers, and with clinical outcomes after cancer diagnosis in several solid tumors. Higher BMI leads to an increased risk of most solid tumors and hematologic malignancies. Exceptions in both sexes include lung and esophageal cancer; in women they also include premenopausal breast cancer (Renehan et al Lancet 2008). Physical inactivity has been convincingly or probably associated with increased risk of cancer of the breast, colon and endometrial cancer and possibly associated with an increased risk of lung, prostate and ovarian cancers; it has been estimated risk of these cancers might be reduced by 20–30% in active individuals (Friedenreich C et al Eur J Cancer 2010). Furthermore, observational data suggest that cancer risk may be reduced in obese individuals who undergo bariatric surgery (Renehan Lancet Oncology 2009) and that risk of obesity-related cancers (breast, colon, endometrial, any obesity associated cancer) is reduced in individuals reported an intentional weight loss of 20 pounds or more. Similar associations have been reported in patients diagnosed with several common types of cancer. For example, higher BMI has been convincingly associated with poor breast cancer outcomes; meta-analyses suggest relative risk of recurrence or death is increased by 25–40% in obese women. Evidence is less convincing for colorectal cancer; obesity may be associated with prostate cancer having more aggressive characteristics. Higher levels of physical activity pre and/or post diagnosis have been associated with improved outcomes in breast and colorectal cancer. One randomized trial involving 2437 early stage breast cancer patients reported improved relapse free survival (HR 0.96, 95%CI 0.60–0.98) in those randomized to a reduced fat diet (associated with modest weight loss) versus controls. A second RCT in breast cancer survivors failed to identify a prognostic effect of a more complex dietary intervention that lowered fat intake but was not associated with weight loss. Intervention studies have convincingly demonstrated that modification of energy balance (physical activity, dietary change, weight loss) in cancer patients is feasible, particularly in those with breast cancer, but confirmation of beneficial effects on cancer outcomes is lacking. Potential physiologic mediators of prognostic effects of energy balance include members of the insulin/insulin-like growth factor pathway, inflammation, adipocytokines and sex hormones; it is likely the relative importance of these factors varies across tumor types. Large scale intervention studies targeting energy balance, its components (e.g. physical activity) and/or key physiologic mediators are needed to provide high level evidence regarding benefits of modifying energy balance, or its physiologic mediators. One study targeting insulin (MA32) is underway in breast cancer survivors; others have been proposed. Citation Information: Cancer Prev Res 2011;4(10 Suppl):PL02-02.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.046 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.005 | 0.009 |
| Insufficient payload (model declined to judge) | 0.018 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".