Trans-NCI Obesity & Cancer Work Group

The Prevention, Etiology, and Mechanisms subgroup is exploring the following challenges in obesity and cancer:

• What are the risk factors, biological mechanisms and pathways associated with obesity/overweight and cancer as it relates to excess body weight and/or adiposity driving the development of pre- and invasive cancers across the lifespan in all racial/ethnic and understudied populations across geographic locations?
• Does overweight/obesity in children and youth increase the risks for cancer development later in life?
• How do risk factors, such as sleep, stress, social determinants of health, the microbiome, metabolic and immune dysfunction, environmental obesogens, influence and/or interact with mechanisms through which obesity might increase risk of cancer?
• What effective strategies could prevent or intercept mechanistic biological changes such as inflammation, immune function, and metabolic dysregulation of obesity associated cancers?
• Does the timing, duration, and amount of weight loss in the life cycle influence cancer risk (i.e. in childhood/youth versus adult)?
• Which interventions decrease obesity and associated unhealthy lifestyle behaviors, applied across the lifespan, to reduce and/or delay cancer incidence?

Co-Chairs

Sharon Ross [DCP]
Ed Sauter [DCP]

The Treatment and Survivorship subgroup is exploring the following challenges in obesity and cancer:

What are the effects of diet, exercise and body composition on cancer treatment efficacy & outcomes?*

• Better characterization of optimal type, dose, frequency, duration, timing of exercise & diet on chemotherapy uptake, adherence, side effects, treatment response & clinical outcomes as it relates to obesity and cancer.
• Greater understanding of the relationships between obesity/body composition, cancer progression, and response to treatment.

What are the effects of obesity/body composition, exercise & dietary regimens on post-treatment outcomes?*

• Better characterization of post-treatment exercise and diet interventions on long-term treatment related toxicities and clinical outcomes, QoL, sleep, and general health outcomes.
• Better precision weight maintenance/loss interventions for cancer survivors.

*These questions need to be addressed across cancer sites/subtypes and in diverse groups of survivors with respect to age, body size, activity level, and race/ethnicity.

Co-Chairs

Tanya Agurs-Collins [DCCPS] 
Joanne Elena [DCCPS]

The Measurement and Methods subgroup is exploring the following challenges related to obesity and cancer:

• How can complementary assessment methods (e.g., self-report, sensor-based technologies, and/or biomarkers) be triangulated to improve insights into diet, physical activity, and sleep behaviors and environmental determinants?
• What assessment and analytic methods are needed to better integrate measures of diet, physical activity, and sleep within the 24-hour day?
• How can assessment tools for modifiable risk factors be developed or adapted and validated for cancer survivors?
• How can methods be enhanced to measure the food and physical activity environment in diverse populations using appropriate reference instruments?

Co-Chairs

Jill Reedy [DCCPS] 
Dana Wolff-Hughes [DCCPS] 

The Health Disparities subgroup is exploring the following challenges in obesity and cancer:

Why do cancer and the health consequences of obesity disproportionately affect Hispanics, non-Hispanic Blacks, and Native Americans more than other race and ethnic groups?

• Geography, economy, health care access, internet access, culturally-sensitive communication, differences in lifestyle, and citizenship status all contribute to the impact of the ability of diverse patient populations to seek and receive cancer information and care related to cancer prevention, screening and treatment - including risks/benefits associated with various treatment modalities - in equitable fashion.
• Need for greater understanding of the intersection of cancer, obesity and disparities within racially-ethnically diverse populations in the basic/translational, clinical and population sciences.
• Enhance understanding of the underlying factors associated with rising obesity rates, especially among vulnerable populations.

How can we tailor interventions influencing weight loss, exercise & dietary regimens to have better outcomes in diverse populations to reduce cancer risk?

• Better characterization of optimal delivery of interventions, type, dose, frequency, duration, timing of exercise & diet on health behavior outcomes & QoL.
• Identify evidence-based interventions and strategies to improve weight, physical exercise, and diet, including effective ways to ensure affordability and address barriers, such as those relating to SES and environmental constraints (e.g. time constraints) that pose obstacles to implementing such strategies.

Co-Chairs

Tanya Agurs-Collins [DCCPS]
Anil Wali [CRCHD] 

The Time-Restricted Eating subgroup is exploring the following challenges in obesity and cancer:

• What are the effects of time-restricted eating (TRE) compared to other diet strategies, including, but not limited to, caloric restriction or other intermittent fasting approaches, on weight loss, weight maintenance, and long-term dietary adherence?
• What role does TRE play in reducing cancer incidence and progression, cancer treatment response, and cancer recurrence?
• What are the emerging obesity risk factors, including the hormonal milieu, microbiome, and epigenetic modifications that impact TRE’s efficacy?

Co-Chairs

Ed Sauter [DCP] 
Marissa Shams-White  [DCCPS] 

The Pediatrics and Physical Activity subgroup is exploring the following challenges in obesity and cancer:

• What is needed to accelerate the application of pediatric exercise and physical activity intervention knowledge from bench to bedside to communities and policy?
• What are research opportunities for exercise, physical activity and physical education for pediatric cancer patients and survivors?
• What role do pediatric exercise and physical activity interventions play in improving cancer treatment outcomes?

Co-Chairs

Heather Bowles [DCP] 
Frank Perna [DCCPS]