Mixed News: Cancer Rates Drop, But More Younger Patients Affected

The latest cancer statistics report from the American Cancer Society (ACS) paints a complex picture of our struggle against the disease. While cancer mortality rates are declining, a worrying trend emerges: younger people are being diagnosed at an increasing rate. This bittersweet news highlights both the progress we’ve made and the challenges that lie ahead.

This week, the Wall Street Journal delved into this story, seeking expert insights from several scientists, including Dr. Karen Glanz, a Penn cancer epidemiology powerhouse. Dr. Glanz, co-leader of the Penn Medicine Abramson Cancer Center’s (ACC) cancer control research program, provided independent commentary on the ACS report, shining a light on both the good and the not-so-good news.

The encouraging side?

The report reveals that 42% of cancers in the US can be attributed to modifiable risk factors like smoking, diet, and lack of exercise. This means that through proactive measures, we can potentially prevent nearly half of all cancer cases. “If we focused on physical activity, diet, and obesity as major risk factors for some cancers, the payoff could be enormous,” Dr. Glanz emphasized.

Dr. Glanz’s leads the Penn Prevention Research Center and the Center for Health Behavior Research and co-leads the Cancer Control Program at ACC. Her ongoing studies focus on promoting physical activity and reducing obesity, directly addressing the modifiable risk factors we can control.

Engage and Collaborate

But Dr. Glanz’s work is also driven by a passion for community engagement. Her leadership in the Philadelphia Communities Conquering Cancer collaboration is a testament to this. This initiative unites leading cancer centers with local leaders, empowering Philadelphians to fight cancer disparities through community-based interventions, resource sharing, and research.

So, while the ACS report reveals a sobering reality for younger cancer patients, it also underscores the immense potential for prevention. By focusing on modifiable risk factors and empowering communities, we can turn the tide on this disease. Research by Dr. Glanz and her colleagues provides a beacon of hope, a testament to the power of research, community engagement, and a relentless pursuit of a healthier future.

The Nutrition Environment Measures Survey (NEMS) – A Systematic Review

A Tool for Understanding the Food Environment

The Nutrition Environment Measures Survey (NEMS) is a set of tools that researchers use to assess the availability of healthy food options in stores and restaurants. NEMS tools have been used in research for over 15 years and have been adapted for diverse settings and populations.

A recent systematic review published in the American Journal of Preventative Medicine (AJPM) examined how NEMS tools have been used in published research. The review found that 190 articles from 18 countries had used NEMS tools. Most studies (69.5%) used a modified version of NEMS tools, and there were 23 intervention studies that used measures from NEMS tools or adaptations as outcomes, moderators, or process assessments.

 

Adapting to the times

The review also found that 41% (n=78) of the articles evaluated inter-rater reliability, and 17% (n=33) evaluated test–retest reliability. This suggests that NEMS tools are generally reliable and valid measures of the food environment.

The review concluded that NEMS measures have played an important role in the growth of research on food environments. NEMS tools have helped researchers to explore the relationships among healthy food availability, demographic variables, eating behaviors, health outcomes, and intervention-driven changes in food environments.

The review also noted that the food environment is constantly changing, so NEMS measures should continue to evolve. Researchers should document the data quality of modifications and use in new settings.

Conclusion

NEMS tools are a valuable tool for understanding the food environment. They have been used in a wide variety of research settings and have helped to advance our understanding of the relationships between the food environment and health. As the food environment continues to change, NEMS tools should continue to evolve to meet the needs of researchers.

Glanz K, Fultz AK, Sallis JF, Clawson M, McLaughlin KC, Green S, Saelens BE. Use of the Nutrition Environment Measures Survey: A Systematic Review. Am J Prev Med., 65:1, 131-142, July 2023. EPub March 2023. doi: 10.1016/j.amepre.2023.02.008. PMID: 36990939.

UPenn DBEI Research Day 2023

The Department of Biostatistics, Epidemiology, and Informatics held its annual Research Day at the University of Pennsylvania, Perelman School of Medicine on March 29, 2023.

Faculty, students, and invited guests presented their latest research to show how we are leading the way in health data science in 2023.

Jeff Leek, PhD, VP, the Brian L. Strom Visiting Prof. Keynote Lecturer with Hongzhe Li, PhD

Karen Glanz, PhD, MPH presented the results of her work with collaborators in Hawaii. The team is studying the Health Behavior and Product Availability Effects of a Ban on Sunscreen Ingredients in Hawaii.

Karen Glanz, PhD, MPH, George A. Weiss University Professor

Learn more about the Ban on Sunscreen Ingredients in Hawaii, click HERE.

A review of the effects of UV filters on the environment and human health

The National Academies presented a public release webinar of a new report on Tuesday, August 9 from 1:00pm to 2:00pm EDT. The report, Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health, calls on the U.S. EPA to conduct an ecological risk assessment of UV filters to characterize possible risks to aquatic ecosystems and the species that live in them. The report contains information useful for such an assessment. It also describes the role of sunscreens in preventing skin cancer and what is known about how human health could be affected by potential changes in usage. The committee chairs shared key takeaways and responded to questions during the webinar.

For further details about the study, visit the project webpage.

UPennPRC and CHBR director and UPenn DBEI faculty, Karen Glanz, PhD, MPH, is on the committee. Dr. Glanz addressed the impact of UV filters on human health and stated the many factors involved, including correct application of sunscreen and the use of other barriers such as rash guards. Read the article on the report that she co-authored for The Conversation, here.

Download the report

View webinar slides

Watch the webinar

Healthy Weigh Study Results

What strategy works better for weight loss in overweight employees?

  • Financial incentives
  • Environment change strategies
  • A combination of the two,
  • On-your-own weight-loss efforts

 

Drs. Karen Glanz and Kevin Volpp, along with the team at the UPenn PRC, found that participants in all groups lost weight. Incidentally, the financial incentives group lost slightly more weight, but none of the strategies netted significantly greater weight losses than the others. The results from their Healthy Weigh Study are currently published in the September 2021 edition of JAMA Network Open.

 

In 2015, the University of Pennsylvania Prevention Research Center (UPenn PRC) conducted a study to test strategies to achieve weight loss and maintain weight loss in urban worksites in Philadelphia.

First, researchers collected data on participants who earned daily financial rewards, in addition to those guided on positive changes to their environment.

Second, they compared each strategy, separately and together, to see which one helped the participants achieve weight-loss.

Third, the team compared that data to those who tried to lose weight on their own.

Ultimately, the goal of the study was to manage obesity by improving nutrition and physical activity, in order to reduce the risk of cardiovascular disease and other chronic health conditions.

 

 

 

 

JAMA Healthy Weigh_visual

Publication

Glanz K, Shaw P, Kwong P, Choi J, Chung A, Zhu J, Huang Q, Hoffer K, Volpp K. Effect of Financial Incentives and Environmental Strategies on Weight Loss in The Healthy Weigh Study: A Randomized Clinical Trial. JAMA Network Open 2021;4(9): e2124132. doi:10.1001/jamanetworkopen.2021.24132

Dr. Glanz named to new NAS committee

National collaboration on sunscreen science

Karen Glanz, PhD, MPH, a George A. Weiss University Professor at the University of Pennsylvania, has been named to a new National Academy of Sciences committee: Committee on Environmental Impact of Currently Marketed Sunscreens and Potential Human Impacts of Changes in Sunscreen Usage. The study is sponsored by the US Environmental Protection Agency (EPA) and managed by the Ocean Studies Board and the National Academy of Medicine’s Health and Medicine Division.

This study will review the state of science on the use of currently marketed sunscreen ingredients, their fate and effects in aquatic environments, and the potential public health implications associated with changes in sunscreen usage.

 

Why is the study being done? 

Concerns have been raised about the potential toxicity of sunscreens to a variety of marine and freshwater aquatic organisms, particularly corals. At the same time, there are concerns that people will use less sunscreen rather than substituting sunscreens with UV filters that are considered environmentally safe.

Karen Glanz has been conducting research in skin cancer prevention for more than 25 years.  She is internationally recognized as a leader in the study of human behavior related to sun protection, and commercial aspects of sunscreen sales and purchases.

COVID-19 Risk Perception, Knowledge, and Behaviors in 6 States

In May 2020, UPenn PRC Director, Karen Glanz, PhD, MPH, received one of the thirteen COVID-19 Rapid Response Research Grants from Penn’s Leonard Davis Institute. 

The study aim is to assess individuals’ risk perceptions, knowledge, and behaviors related to prevention of COVID-19, response to the pandemic, and psychological impacts of quarantine and/or diagnosis of COVID-19. Primary outcomes are: individuals’ behaviors, risk perceptions, knowledge, and behaviors related to prevention and the impact of the COVID-19 pandemic. Secondary outcomes are: changes in risk perceptions, knowledge, and behaviors about the COVID-19 pandemic over time, by geographic area, and by personal experience with the disease.

Karen Glanz, PhD, MPH

Principal Investigator:
Karen Glanz, PhD, MPH

John Holmes, PhD

Co-Investigator:
John Holmes, PhD

UPenn PRC helps to accelerate implementation of evidence-based cancer prevention and control

Accelerate progress

The Evidence Academy model was developed to bring together researchers, health professionals, advocates, and policy makers to accelerate the process of integrating research findings into practice.

Bringing in the experts

The University of Pennsylvania Collaborating Center of the Cancer Prevention and Control Research Network (CPCRN) assembled local and national experts in three different Evidence Academies (EAs) on the UPenn campus from 2015 to 2018.

The EAs were used to present research and discuss barriers and solutions to topics that affect the health of our communities. As a result, an article describing three evidence academies and the lessons learned was just published in the journal Preventive Medicine.

The Topics

The focus of the Evidence Academies were:
Prostate cancer (2015)
Food access, diet and obesity (2017)
Tobacco control science (2018)

The paper on these EAs is a part of a special supplemental issue, produced by the CPCRN which is funded by the CDC’s Division of Cancer Prevention and Control and the National Cancer Institute.

The goal of the network is to reduce the impact of cancers that affects all communities, by connecting public health practitioners, policymakers, and others to the research and strategies found to be most effective. Twelve articles come from centers across the United States linked by a common cause, “reducing cancer burden in diverse populations.”

The cancer prevention and control research network: Accelerating the implementation of evidence-based cancer prevention and control interventions (Guest Editor Commentary). Leeman J, Glanz K, Hannon P, Shannon J.

An application of the Science Impact Framework to the Cancer Prevention and Control Research Network from 2014-2018. Ko LK, Jang SH, Friedman DB, Glanz K, Leeman J, Hannon PA, Shannon J, Cole A, Williams R, Vu T.

*This issue is open access

AUDIO: Cutting down on Food Waste

LISTEN: On Thursday, June 6, 2019, UPenn PRC director Karen Glanz participated in a discussion on Business Radio Powered by The Wharton School, Penn’s Sirius XM station, on the FDA’s attempts to make best by dates less confusing for consumers and thus cut down on food waste.

 

The conversation included the show’s host, Dan Loney, and Catherine Donnelly of the University of Vermont. They discussed a standardized “Best if used by” date on food labels, in order to give consumers a clear idea of a packaged food product’s shelf life. Click the link above to hear the conversation.

 

This broadcast originally aired on Sirius XM Channel 132, Business Radio Powered by The Wharton School.

https://www.fda.gov/consumers/consumer-updates/confused-date-labels-packaged-foods

 

In the past there have been different terms used to communicate to consumers and retailers about packaged food products, like “use before,””sell by” and “packaged on,” etc. It can be confusing to consumers when it comes to storing, using and disposing of these products. “About 40% of the food that is produced in the United States is prematurely discarded and 20% is due to confusion around these date labels, ” says Donnelly. “Creating the standardization will get us all back on the same page. This is a great start to get us all back to a common area and from there we can disseminate more information that can get down to more specifics about potentially hazardous foods, shelf-stable products, etc.”

 

“There are layers on top of layers here, and when you talk about how we relate to food compared to 20 – 30 years ago, we’re cooking much less, so we’re relying more on combination foods, processed foods, packaged foods,” says Glanz. “I can only hope that the FDA and the federal agencies don’t stop at making this standardization suggestion to industry, but carry on with education efforts, working with the USDA, and existing organizations. I also hope they will support additional research.”

 

Learn more about the suggested standardization here.

Research Day 2019

Highlights from Research Day on March 21, 2019

A joint project of the DBEI and the Center for Clinical Epidemiology and Biostatistics at Penn.

Karen Glanz, PhD, MPH started off the day with her Featured Faculty Talk, “Food and Nutrition Environments: Is There an Elephant in the Room?” In addition to her informative talk, investigators from the UPenn PRC contributed two projects to the Poster Session. One features the message development and testing from our Skin Cancer Communication Project and the other highlights the methods and results from our core research project, The Healthy Weigh Study.

We also enjoyed the keynote with Peter Embi, MD, MS, FASP, FACMI from Indiana University School of Medicine with his personal journey through diagnosis and treatment and how the whole health system could better serve patients.

To download photos from this event, visit our Facebook album. View tweets from the event by searching #2019ResearchDay on Twitter.

Watch video and coverage of the Featured Faculty Talks here!

Article by Glanz and her team receives honor from major nutrition journal

Karen Glanz, PhD, MPH

UPenn PRC Director Karen Glanz, MPH, PhD and her co-authors received the 2019 High-Impact Award from the Journal of Nutrition Education and Behavior (JNEB) for a highly cited paper published in 2016. The publication focuses on synthesizing the evidence about how researchers measure the presence of healthful food and beverage options are in food stores – an issue of growing public interest in efforts to promote healthy eating.

Read the paper here.

 

 

Glanz K., Johnson L., Yaroch A.L., Phillips M., Ayala G.X., Davis E.L.
Measures of Retail Food Store Environments and Sales: Review and Implications for Healthy Eating Initiatives J Nutr Educ Behav 2016; 48(3)