Breast Cancer Clinical Trial
Official title:
Prevention of Obesity-related Cancers: Setting up of a Multi-Cancer Education and Prevention Program in Hong Kong
Obesity could increase the risk of many chronic diseases, including hypertension,
cardiovascular diseases, high lipid level, diabetes, stroke, endometrial cancer and certain
types of cancer which could benefit by secondary prevention through screening programs. The
World Cancer Research Fund of the American Institute for Cancer Research has reviewed all the
studies about the link between obesity and cancer. Studies shown that obesity is an
independent risk factor for colorectal, breast and prostate cancer. These three cancers (will
be named as "obesity-related cancers" thereafter) demonstrate a rapidly increasing trend of
incidence in Asia in the past decade.
Among Chinese adults of Hong Kong in 2014, 39% were overweight or obese (compared with 20.9%
reported in European adults in the same year) and up to 69.7% reported that they did not
perform any measures to achieve optimal weight control. Men (49.6%) had a higher proportion
of overweight or obesity than females (29.5%). Adults who are aged 45-54 had the highest rate
(50.5%) of overweight or obesity than other age groups. In addition, there were 62.5% whose
physical activity level did not meet the recommendations from the World Health Organization
(WHO). Only 18.7% consumed at least 5 portions of fruit and vegetables per day; yet about 30%
were alcoholic drinkers; and more than 10% were daily or occasional smoker. These figures
imply that the incidence of obesity and obesity-related cancers will further escalate - and
urgent actions at the community level are needed to combat the rising incidence and mortality
of these conditions.
According to Hong Kong Cancer Registry, the discrepancy between the number of new cases
(incidence) and number of deaths (mortality) is much higher for colorectal, breast and
prostate cancer as compared to other cancers. It is well recognized that screening could
effectively reduce mortality for these three obesity-related cancers when they are detected
at an earlier stage.
The concept of a one-stop approach to screen for multiple cancers was found to be feasible,
with an ability to detect a wide range of neoplastic lesions at an early stage. In the recent
decade, there are also emerging centres that have been established as multi-cancer screening
clinics worldwide. Nevertheless, there is a scarcity of studies that have highlighted the
outcomes of these multi-cancer screening programs.
Obesity could increase the risk of many chronic diseases, including hypertension,
cardiovascular diseases, high lipid level, diabetes, stroke, endometrial cancer and certain
types of cancer which could benefit by secondary prevention through screening programs. In
particular, colorectal, breast and prostate cancer (these three cancers will be named as
"obesity-related cancers" thereafter) demonstrate a rapidly increasing trend of incidence in
Asia in the past decade. The World Cancer Research Fund of the American Institute for Cancer
Research has reviewed all the studies about the link between obesity and cancer . For
colorectal cancer (CRC), there is compelling evidence suggesting that obesity is associated
with 30-66% higher risk of developing CRC. Weight gain during adulthood was also shown to
increase risk of CRC. As for breast cancer, post-menopausal women with the smallest waist
(compared with the largest) had 39% lower risk of getting breast cancer . A 5-unit increase
in BMI is associated with 12% increased risk of breast cancer, and this figure escalates to
20-40% for postmenopausal women. For prostate cancer, greater body fatness has been suggested
as a reason of advanced prostate cancer. Obesity was positively related to advanced stage
prostate cancer. The relative risk is 1.09 for every 5 kg/m2 higher BMI.
Among Chinese adults of Hong Kong in 2014, 39% were overweight or obese (compared with 20.9%
reported in European adults in the same year) and up to 69.7% reported that they did not
perform any measures to achieve optimal weight control. Men (49.6%) had a higher proportion
of overweight or obesity than females (29.5%). Adults who are aged 45-54 had the highest rate
(50.5%) of overweight or obesity than other age groups. In addition, there were 62.5% whose
physical activity level did not meet the recommendations from the World Health Organization
(WHO). Only 18.7% consumed at least 5 portions of fruit and vegetables per day; yet about 30%
were alcoholic drinkers; and more than 10% were daily or occasional smoker. These figures
imply that the incidence of obesity and obesity-related cancers will further escalate - and
urgent actions at the community level are needed to combat the rising incidence and mortality
of these conditions.
As shown in Figure 2, the discrepancy between the number of new cases (incidence) and number
of deaths (mortality) is much higher for colorectal, breast and prostate cancer as compared
to other cancers. It is well recognized that screening could effectively reduce mortality for
these three obesity-related cancers when they are detected at an earlier stage.
Primary prevention is one of the crucial strategies found to be effective in cancer
prevention. Health education on modification of lifestyle factors is especially useful to
change behavior and reduce the impact of the threats posed by obesity and its related
cancers. The application of behavioral medicine, defined as "the interdisciplinary field
concerned with the development and integration of sociocultural, psychosocial, behavioral,
and biomedical knowledge relevant to health and illness and the application of this knowledge
to disease prevention, health promotion, etiology, diagnosis, treatment, and
rehabilitation'', has been considered to be the most effective and practical means to prevent
cancers. A comprehensive strategy for reducing cancers also includes secondary prevention
that aims at early detection of diseases. Early detection for some "screen-relevant" cancers
is particularly effective to reduce cancer-related mortality.
The concept of a one-stop approach to screen for multiple cancers is relatively novel from
existing literature - and one of such initiatives is the "Integrated Cancer Prevention
Centre" (ICPC) established in Tel Aviv Sourasky Medical Center at Israel in 2006. Analysis of
the first 1,000 subjects visiting the centre showed that the compliance at the centre was
higher than those seen in the Ministry of Health for the general population (78% vs. 60% for
mammography; 39% vs. 16% for colonoscopy). The provision of such a unique facility designed
for one-stop screening for multiple cancers was found to be feasible, with an ability to
detect a wide range of neoplastic lesions at an early stage. In the recent decade, there are
also emerging centres that have been established as multi-cancer screening clinics worldwide.
Nevertheless, there is a scarcity of studies that have highlighted the outcomes of these
multi-cancer screening programs.
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT04681911 -
Inetetamab Combined With Pyrotinib and Chemotherapy in the Treatment of HER2 Positive Metastatic Breast Cancer
|
Phase 2 | |
Completed |
NCT04890327 -
Web-based Family History Tool
|
N/A | |
Terminated |
NCT04066790 -
Pyrotinib or Trastuzumab Plus Nab-paclitaxel as Neoadjuvant Therapy in HER2-positive Breast Cancer
|
Phase 2 | |
Completed |
NCT03591848 -
Pilot Study of a Web-based Decision Aid for Young Women With Breast Cancer, During the Proposal for Preservation of Fertility
|
N/A | |
Recruiting |
NCT03954197 -
Evaluation of Priming Before in Vitro Maturation for Fertility Preservation in Breast Cancer Patients
|
N/A | |
Terminated |
NCT02202746 -
A Study to Assess the Safety and Efficacy of the VEGFR-FGFR-PDGFR Inhibitor, Lucitanib, Given to Patients With Metastatic Breast Cancer
|
Phase 2 | |
Active, not recruiting |
NCT01472094 -
The Hurria Older PatiEnts (HOPE) With Breast Cancer Study
|
||
Completed |
NCT06049446 -
Combining CEM and Magnetic Seed Localization of Non-Palpable Breast Tumors
|
||
Withdrawn |
NCT06057636 -
Hypnosis for Pain in Black Women With Advanced Breast Cancer: A Feasibility Study
|
N/A | |
Recruiting |
NCT05560334 -
A Single-Arm, Open, Exploratory Clinical Study of Pemigatinib in the Treatment of HER2-negative Advanced Breast Cancer Patients With FGFR Alterations
|
Phase 2 | |
Active, not recruiting |
NCT05501769 -
ARV-471 in Combination With Everolimus for the Treatment of Advanced or Metastatic ER+, HER2- Breast Cancer
|
Phase 1 | |
Recruiting |
NCT04631835 -
Phase I Study of the HS-10352 in Patients With Advanced Breast Cancer
|
Phase 1 | |
Completed |
NCT04307407 -
Exercise in Breast Cancer Survivors
|
N/A | |
Recruiting |
NCT03544762 -
Correlation of 16α-[18F]Fluoro-17β-estradiol PET Imaging With ESR1 Mutation
|
Phase 3 | |
Terminated |
NCT02482389 -
Study of Preoperative Boost Radiotherapy
|
N/A | |
Enrolling by invitation |
NCT00068003 -
Harvesting Cells for Experimental Cancer Treatments
|
||
Completed |
NCT00226967 -
Stress, Diurnal Cortisol, and Breast Cancer Survival
|
||
Recruiting |
NCT06006390 -
CEA Targeting Chimeric Antigen Receptor T Lymphocytes (CAR-T) in the Treatment of CEA Positive Advanced Solid Tumors
|
Phase 1/Phase 2 | |
Recruiting |
NCT06037954 -
A Study of Mental Health Care in People With Cancer
|
N/A | |
Recruiting |
NCT06019325 -
Rhomboid Intercostal Plane Block on Chronic Pain Incidence and Acute Pain Scores After Mastectomy
|
N/A |