University of Arizona
Presentation Abstract
Addressing “At Risk” Populations
Background: Advancements in treatment and precision oncology care will continue to improve outcomes after cancer, however, without a purposeful effort to address malnutrition, mortality rates will remain suboptimal and quality of life after diagnosis will be diminished. The goal of this presentation is to review risk factors associated with poor outcomes, with an emphasis on under-represented cancer survivors – older, race and ethnically diverse, and rural residing survivors - and to identify gaps and future directions necessary to address these disparities.
Main content: Risk factors that are modifiable with medical nutrition therapy and consequential for cancer outcomes include: weight/body composition management, comorbidity, treatment-associated symptoms, and lifestyle behaviors. Frequently, these risk factors are exacerbated in individuals who experience health disparities including race and ethnic groups, those living in poverty, older adults, and those living in rural, border and tribal communities. As examples, diabetes, liver disease and obesity rates are much higher in Hispanic, Black and American Indians; symptom burden may be higher in older survivors; adherence to diet and physical activity guidelines is lower for non-White Americans; poverty rates as well as tobacco use are higher for rural families; and inactivity increases with advancing age. Demonstrated differences in cancer care (e.g., treatment delay, reduced dosing, financial toxicity) all contribute to malnutrition. There is a dearth of studies that have evaluated nutrition interventions to improve outcomes among diverse cancer patients and none in active treatment.
Summary: Future research should build toward an evidence base that can secure third party reimbursement for nutrition screening and care for all survivors. This evidence must address the differential risks of diverse groups, provide individual and multilevel strategies to support greater precision in medical nutrition therapy, and advance the training and research leadership roles of diverse researchers from these populations, to achieve a larger impact on cancer outcomes for all.
About Dr. Thomson
Dr. Cynthia Thomson, Ph.D., RDN leads a multidisciplinary research program in cancer prevention research focusing on lifestyle behaviors, cancer prevention, and survivorship. Her translational research program integrates novel interventions including mobile health technologies and delivery systems, as well as behavioral theory and cancer-relevant biomarker research to advance understanding of optimal health behaviors to improve health after a cancer diagnosis. Her research predominantly focuses on obesity-related cancers (breast, ovarian, colorectal) and includes dissemination and implementation science to expand the impact of her evidence-based research.
Dr. Thomson did not disclose any conflicts of interest for this workshop.