David Weinkove, BSRA Chair
One of the main aims of research on the biology of ageing is to find ways to keep people healthier for longer. Those working on the prevention of specific diseases have the same aim. Thus, there are mutual benefits of working together and by doing so it provides a clear route to translation of research on the biology of ageing. For this reason, and inspired by a Cancer Research UK workshop on the subject, I represented the British Society for Research on Ageing at the Cancer Prevention Conference 2025 in London in late June run by CRUK and The American Cancer Society.
Sir John Burn, on prevention of bowel cancer using aspirin and the challenges of prevention trials.
It was a fascinating conference. It helped that I had worked in cancer research institutes earlier in my career but much of the discussion had direct relevance to the biology of ageing. The paradigm in cancer research is that cells need a certain number of mutations in key genes to become a tumour. However, in the era of next generation sequencing, it is clear that with age, the body accumulates a huge number of clones of mutated cells but the vast majority do not become cancerous. Also, many carcinogens promote cancer but do not cause significant mutations, so mutation is not the only mechanism that causes cancer. Allan Balmain explained this well and that promotion of cancer happens for reasons beyond the original cell – for example changes to the microenvironment of the cell and more systemic factors such as the immune system. Thus, the link between ageing and cancer is not just the accumulation of mutations with time but also the breakdown of processes that prevent cancers developing. Margarete Fabre gave a really interesting talk about how clonal expansions of mutated somatic cells accumulate with age, that they rarely give rise to cancer, but they can lead to a decline in function, because they are selected for expansion rather than function. Her work was focussed on haematopoietic cells, where clonal expansions disrupt immune function but the fundamental principles were applicable to other tissues.
A session focussed on ageing, genetics and cancer risk provided some more explicit reference to ageing with Alex Cagan in particular getting a lot interest from delegates discussing why whales and other large animals don’t get cancer despite having so many more cells than smaller animals like mice. He made the point that large mammals evolved independently at least 8 times and in all cases they had solved this issue. Great to get cancer biologists thinking about the evolution of ageing!
When it came to the discussion of trials for prevention, the parallels to the challenges for ageing research were very clear. The trials need to be large and take time, and you need to start with an at-risk group. In the case of low-dose aspirin, Sir John Burn showed how it prevents cancer in people with Lynch syndrome, who are at risk of bowel cancer, but is likely to be more widely beneficial. Karen Brown described her ongoing trials with metformin together with aspirin and resveratrol in patients at risk of colorectal cancer. It was striking how much work and time it involved, with recruitment of patients at the numbers required being a real challenge.
There were many other subjects of interest to researchers working on ageing including tackling obesity to prevent cancer and how GLP-1 agonists might help. We learnt from the World Cancer Atlas that treatment in many parts of the developing world was not an option due to a lack of radiotherapy machines and surgeons and thus for a huge number of people in the world, prevention is the only option. Despite this need, prevention of disease is still an underdeveloped science and clinical approach compared to treatment and this conference was aimed at changing that for cancer.
I would definitely recommend this conference to BSRA members (next year in Atlanta, Georgia) and the BSRA annual conference in September for those working on the prevention of cancer or any other disease. We will have a number of disease-specific charities including CRUK represented in a special session on how we can work together to prevent disease.