The Role of Nutrition and Malnutrition as Determinants of Cancer Development, Prevention, and Survivorship.

Nutrition and malnutrition are highly influential yet often under recognized determinants in the development, progression, and survivorship of cancer. Poor dietary patterns and nutritional deficiencies are leading modifiable risk factors for several types of cancers. These issues disproportionately affect vulnerable populations, intensifying existing health disparities. In Delaware, the Bureau of Cancer Prevention and Control addresses cancer across the continuum from education and prevention to screening, diagnosis, treatment, and survivorship. This is done through integrated programs such as the Delaware Comprehensive Cancer Control Program, Screening for Life, the Physical Activity, Nutrition and Obesity Prevention Program, and the Delaware Cancer Treatment Program. This article explores the complex interplay between nutrition and malnutrition, and their impact on cancer. Highlighted are both the biological mechanisms linking dietary patterns to carcinogenesis and the socioeconomic factors that drive nutritional inequities. It also presents Delaware-specific cancer and nutrition data, highlighting how state-led efforts are evolving to incorporate nutrition education, food access partnerships, and community-based interventions into cancer prevention and control strategies. By aligning clinical, public health, and community resources, Delaware is creating a more holistic and equitable approach to reducing cancer incidence and improving outcomes. This article underscores the urgent need to treat nutrition as a foundational element of cancer prevention and presents opportunities for policy and practice to address malnutrition across the cancer care continuum.