Translational and transdisciplinary research in energy balance and cancer: past is prologue.
Translational and transdisciplinary research in energy balance and cancer: past is prologue.
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能量平衡和癌症的转化和跨学科研究：过去是序幕。
DOI：
10.1093/jncimonographs/lgad009
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Ligibel,Jennifer
中科院分区：
文献类型：
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作者：
Irwin,MelindaL;Sears,DorothyD;Ligibel,Jennifer
肥胖定义为体重指数30 kg/m2，与13种癌症的发病率增加和14种癌症的死亡率增加相关（1，2）。肥胖与不良饮食和缺乏身体活动密切相关，这也是癌症发病率和死亡率的独立风险因素（3-5）。据估计，到2030年，肥胖将超过烟草，成为最常见的可预防的癌症风险因素。今天，大约40%的美国成年人的体重指数> 30 kg/m2，黑人和西班牙裔人的体重指数明显更高，尤其是女性（6）。肥胖率和相关因素的上升可能会减缓癌症预防和治疗的进展，强调了对身体成分，身体活动和饮食在癌症风险和结果中的因果作用进行研究的迫切需要。我们对能量平衡与癌症之间关系的理解存在重大差距。迄今为止，大部分证据都集中在乳腺癌上，这些乳腺癌是由具有早期恶性肿瘤的中高社会经济地位的个体产生的（4）。需要开展研究，以了解肥胖在影响研究不足的肥胖相关癌症的风险和结果方面的作用，并了解在少数种族和族裔、正在接受积极治疗或患有转移性疾病的患者、低收入和生活在农村环境中的癌症幸存者以及年轻和老年人口中的作用。需要机制研究来阐明能量平衡与微生物组，表观遗传学，免疫功能，免疫治疗和癌症的关系。还需要研究如何在肿瘤学实践中有效实施和传播生活方式干预措施。此外，研究必须侧重于如何在个人和社区两级制定和评估成功的多层次干预战略。国家癌症研究所2022财年年度计划和预算提案将肥胖和癌症作为一个科学主题，并强调了投资培训下一代癌症研究人员的重要性。需要跨学科的培训，使研究人员能够创新地解决这些复杂的问题。美国国家癌症研究所资助的“能量学和癌症跨学科研究（TREC）培训计划”是一个为期一周的年度住院培训课程，包括指导和实质性的网络。该计划是面向
Obesity, defined as a body mass index 30 kg/m2, is associated with an increased incidence of 13 cancers and increased mortality of 14 cancers (1, 2). Obesity is strongly linked to poor diet and physical inactivity, which are also independent risk factors for cancer incidence and mortality (3-5). Estimates suggest that by 2030 obesity will overtake tobacco as the most common preventable risk factor for the development of cancer. Today, approximately 40% of US adults have a body mass index> 30 kg/m2, with rates significantly higher in Black and Hispanic individuals, especially women (6). Rising rates of obesity and associated factors threaten to slow advances in cancer prevention and treatment, underscoring the critical need for research on the causal role of body composition, physical activity, and diet in cancer risk and outcomes.Substantial gaps exist in our understanding of the relationship between energy balance and cancer. Much of the evidence to date has focused on breast cancer, generated from individuals of middle-to-higher socioeconomic status with early-stage malignancies (4). Research is needed to understand the role of obesity in influencing risk and outcomes of understudied obesityassociated cancers and in racial and ethnic minorities, patients undergoing active treatment or who have metastatic disease, cancer survivors with low income and who live in rural settings, as well as younger and geriatric populations. Mechanistic research is needed to elucidate associations of energy balance with the microbiome, epigenetics, immune function, immunotherapy, and cancer. Research is also needed on how to effectively implement and disseminate lifestyle interventions in oncology practice. In addition, research must focus on how to develop and assess successful multi-level intervention strategies at the individual and community levels. The National Cancer Institute Fiscal Year 2022 Annual Plan and Budget proposal featured obesity and cancer as a scientific topic and highlighted the importance of investing in training the next generation of cancer researchers (7). Transdisciplinary training is needed to prepare researchers to innovatively address these complex topics. The National Cancer Institute–funded “Transdisciplinary Research in Energetics and Cancer (TREC) Training Program” is an annual 1-week, in-residence training course that includes mentoring and substantial networking. The program is geared