The potential yield of active play in the prevention of cancer

Literature has shown that participation in physical activity is associated with a reduction in the incidence of certain cancers. Physical activity levels across the life course are low. Since cellular damage from an inactive lifestyle accumulates over time, promoting physical activity from childhood is fundamental for cancer prevention. To date, interventions to promote physical activity in children have been unsuccessful over the long term. Physical activity can be accrued through several domains including sport and active play. Research suggests that sport participation and not active play tracks from childhood to adulthood. Active play is easier to promote because it does not necessitate a certain level of skill or competency, and is enjoyable. The purpose of the present paper is to encourage more research into all areas of active play to increase population physical activity levels across the life course and thus aid in the prevention of specific cancers

Feasibility of home-based exercise training during adjuvant treatment for metastatic castrate-resistant prostate cancer patients treated with an androgen receptor pathway inhibitor (EXACT)

BackgroundExercise is an effective adjuvant therapy that can alleviate treatment-related toxicities for men with prostate cancer (PC). However, the feasibility of delivering exercise training to men with advanced disease and the wider impact on clinical outcomes remain unknown. The purpose of the EXACT trial was to determine the feasibility and effects of home-based exercise training in men with metastatic castrate-resistant prostate cancer (mCRPC). MethodsPatients with mCRPC receiving ADT + an androgen receptor pathway inhibitor (ARPI) were prescribed 12 weeks of home-based, remotely monitored, moderate intensity, aerobic and resistance exercise. Feasibility was assessed using recruitment, retention and adherence rates. Safety and adverse events were monitored throughout, with functional and patient-reported outcomes captured at baseline, post-intervention and at 3-month follow-up. ResultsFrom the 117 screened, 49 were deemed eligible and approached, with 30 patients providing informed consent (61% recruitment rate). Of those who consented, 28 patients completed baseline assessments, with 24 patients completing the intervention and 22 completing follow-up (retention rates: 86% and 79% respectively). Task completion was excellent throughout, with no intervention-related adverse events recorded. Self-reported adherence to the overall intervention was 82%. Exercise training decreased mean body mass (−1.5%), improved functional fitness (> 10%) and improved several patient-reported outcomes including clinically meaningful changes in fatigue (p = 0.042), FACT-G (p = 0.054) and FACT-P (p = 0.083), all with moderate effect sizes. ConclusionHome-based exercise training, with weekly remote monitoring, was feasible and safe for men with mCRPC being treated with an ARPI. Given that treatment-related toxicities accumulate throughout the course of treatment, and as a result, negatively impact functional fitness and health-related quality of life (HRQoL), it was positive that exercise training improved or prevented a decline in these clinically important variables and could better equip patients for future treatment. Collectively, these preliminary feasibility findings support the need for a definitive, larger RCT, which downstream may lead to the inclusion of home-based exercise training as part of adjuvant care for mCRPC

Improving HPV vaccine uptake in children, adolescents,and young adults - An umbrella review of interventions

HPV causes about 5% of all cancers worldwide. The most common of these cancers is cervical but the virus is also implicated in cancers of the vagina, vulva, anus, penis, head and neck. A significant proportion of the cancers caused by HPV in Europe are in men. The World Health Organization now has a global strategy for the elimination of cervical cancer. Europe’s Beating Cancer Plan, published by the European Commission in 2021, contains a ‘flagship’ commitment to HPV vaccination. Both strategies share the goal of a 90% vaccination uptake for girls and the Beating Cancer Plan also wants to see an increasing number of boys vaccinated through gender-neutral programmes in every member state. But vaccination rates in Europe, and elsewhere, currently vary widely. Data for the European region shows that only two countries achieved a 90% uptake of girls receiving all their vaccine doses. While several managed over 70% uptake, other countries had coverage rates of below 50% and at least two currently vaccinate fewer than 10% of girls. An important part of the explanation for sub-optimal vaccination rates is low vaccine confidence among parents and carers as well as young people themselves. This can be caused by insufficient information, a lack of trust in health authorities and vaccine manufacturers, and concerns about vaccine safety. But we know that vaccine confidence can be improved, and vaccine uptake increased if the right policies and programmes are put in place. That is why the European Cancer Organisation’s HPV Action Network commissioned this important review of published evidence. Our expert research team took a detailed look at the existing evidence base, by means of an umbrella review (essentially a systematic review of systematic reviews) and identified a range of interventions that have been shown to make a difference in terms of intention to be vaccinated, and uptake rates for HPV vaccination. Compared to many other cancer prevention strategies – such as tobacco control, reducing alcohol consumption, increasing physical activity or tackling obesity – HPV vaccination is easy-todeliver, has an immediate positive health impact and is highly efficacious. In fact, it is probably the single most effective means of cancer prevention in the medical arsenal. We will therefore share these findings widely and encourage HPV vaccination programmes in Europe and beyond to make the best possible use of this evidence. If we can achieve a 90% vaccination rate across Europe, we know we will succeed in eliminating HPV cancers as a public health problem in the region