Cancer Epidemiology Research Programme - Institute of Oncology (ICO)

The Unit of Nutrition and Cancer (UNAC) comprises a multidisciplinary team of epidemiologists, nutritionists, biologists and statisticians. It focuses primarily on aetiological research into the relationship between nutrition and cancer. This includes diet and dietary patterns, body composition and physical activity as possible determinants of cancer, as well as genetic susceptibility in human carcinogenesis. UNAC also researches the role of nutritional factors in the prognosis of cancer patients and survivors. To achieve this, it combines traditional epidemiological approaches with more innovative tools including exposure and susceptibility biomarkers.

Historically, most research by UNAC has been carried out under the European Prospective Investigation into Cancer and Nutrition (EPIC), in collaboration with the European Union, IARC/WHO and Imperial College London (https://epic.iarc.fr/). EPIC is a multicentric cohort study with a primary objective to investigate the relationship between nutrition, lifestyle, genetic and environmental factors and the incidence of cancer and other chronic diseases. UNAC is engaged in several EPIC-related areas of research and leads the working group on gastric and oesophageal cancer. The Unit recently developed new research lines looking at the aetiology of hormone-related cancers, mainly endometrial and ovarian cancers. UNAC also works closely with other EPIC working groups on breast, lung, prostate and colorectal cancers. So far, EPIC has identified more than 90,000 cancer cases and is one of the largest existing studies of this type in the world, pooling data from approximately 500,000 individuals followed for almost 20 years in 10 European countries, including Spain.

There is growing interest in the potential role of nutrition in the prognosis and progression of disease in cancer survivors, mainly in common cancers causally related to diet. Interventional studies are needed to confirm the role of these lifestyle factors on cancer prognosis and to establish specific recommendations. UNAC coordinates a multicentre randomised clinical trial (PREDICOP) to assess the effect of a lifestyle intervention (combining weight control, diet and physical activity) on the risk of recurrence among breast cancer patients, as well as the effect of the intervention on survival and quality of life. This on-going trial aims to include around 2,000 women diagnosed with non-metastatic breast cancer. Participants will be placed either in an intervention or a control group and followed for five years. Patients in the intervention group will take part in a lifestyle programme with two components: the dietary part will aim to achieve a calorie reduction while maintaining nutritional quality; the physical activity part will include supervised exercise sessions of moderate intensity.

Primary research areas:

Nutritional epidemiology, cancer and other chronic diseases
Research on the role of lifestyles in the aetiology of various tumour sites, including the role of nutrition (dietary patterns, chrono-nutrition, dietary components as potential carcinogens), physical activity and sedentary behaviour, and body composition, among others.
Diet, physical activity and body composition in cancer patients and survivors
Research into the role of lifestyle (diet, physical activity), body composition and behavioural changes in the prognosis and quality of life of cancer patients and survivors, including observational studies, clinical trials and community-based interventions.
Epidemiology of gastric and oesophageal cancer
Research on the role of environmental factors (diet, alcohol consumption, tobacco smoking) and their possible interactions with the host's genetic susceptibility in the risk of gastric and oesophageal cancer.
Polyphenols and other bioactive dietary components in cancer and other chronic diseases
Study of the relationship between polyphenols and polyphenol-rich diets in the incidence and prognosis of cancer and other chronic diseases. Improvement of dietary assessment of polyphenol exposure: biomarkers of intake and metabolomics, among others.
Molecular epidemiology of hormone-dependent tumours
Research into the influence of lifestyles and other environmental exposures on the molecular mechanisms underlying the aetiology and progression of hormone-dependent tumours (breast, endometrial and ovarian cancer, among others). Identification of biomarkers linking environmental and lifestyle exposures to the risk and prognosis of these tumours.
Nutrition, lipid metabolism, and cancer.
Investigation into the role of nutrition and lipid metabolism in cancer and other chronic diseases through observational studies and nutritional interventions. Identification of novel biomarkers related to lipid metabolism for the prevention and prognosis of cancer.