From evidence to implementation of lifestyle behaviour in cancer prevention and control: A Preventive Medicine Golden Jubilee Commentary

Characterized by a combined lack of physical activity and prolonged sitting, sedentary lifestyle has become highly prevalent and, in principle, modifiable to reduce the cancer burden. Population health interventions are required to shift sedentary to active lifestyles through an equitable approach. At this timepoint, the relevant question is how to design and implement scalable interventions targeting behavioral risk factors for cancer prevention and control? In this paper, we propose a translational research framework to illustrate the non-linear process from evidence generation to implementation, and articulate the need to incorporate systems thinking, casual thinking and design thinking to accelerate implementation. We use the case for the role of physical activity-related behaviour and cancer to illustrate the iterative, multidirectional, and transdisciplinary nature of translational research. The issues we address in this context are generalizable and applicable to other behavioral risk factors and non-communicable diseases.

One of the most significant achievements in human health in the past century was the extension of life expectancy from 45 to 75+ years, resulting in an expanding aging population (Crimmins, 2021; Roser et al., 2016). Meanwhile, lifestyle has changed with industrialization, inducing dramatic shifts in global disease burdens now dominated by non-communicable diseases (Lim et al., 2012; Scarborough et al., 2011; World Health Organization, 2020). Interventions targeting tobacco, alcohol, healthy diets and physical activity are key strategies to tackle the most pressing health challenges in modern society (World Health Organization, 2017). Except for tobacco control, we have made limited progress on achieving sustainable positive changes in major risk factors at the population level by taking research evidence into real-world implementation.

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