Adherence to the World Cancer Research Fund/American Institute for Cancer Research 2018 Recommendations for Cancer Prevention and Risk of Colorectal Cancer

Abstract

Background: The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) 2018 diet, nutrition, and physical activity recommendations aim to reduce cancer risk. We examined adherence to the WCRF/AICR recommendations and colorectal cancer risk in two prospective cohorts.Methods: We followed 68,977 women in the Nurses' Health Study and 45,442 men in the Health Professionals Follow-up Study from 1986 until 2012. We created cumulatively averaged WCRF/AICR scores using updated diet, adiposity, and physical activity data from questionnaires, and used Cox regression to estimate sex-specific HRs and 95% confidence intervals (CI) for incident colorectal cancer.Results: We documented 2,449 colorectal cancer cases. Men in the highest quintile of the WCRF/AICR lifestyle score had a lower risk of colorectal cancer compared with those in the lowest quintile (HR Q5vsQ1 ¼ 0.64; 95% CI, 0.52-0.77).The result was weaker in women (HR Q5vsQ1 ¼ 0.86; 95% CI, 0.72-1.02; P heterogeneity by sex ¼ 0.006). When analyzing the diet recommendations alone, we similarly observed stronger inverse associations in men (HR Q5vsQ1 ¼ 0.74; 95% CI, 0.61-0.90) compared with women (HR Q5vsQ1 ¼ 0.93; 95% CI, 0.77-1.12; P heterogeneity by sex ¼ 0.06). In men, the lifestyle score was more strongly inversely associated with risk of distal colon cancer compared with proximal colon or rectal cancer (P common effects ¼ 0.03); we did not observe significant differences between anatomic locations in women.Conclusions: The 2018 WCRF/AICR cancer prevention recommendations are associated with lower colorectal cancer risk in men, with weaker results in women.Impact: Consideration of adiposity and physical activity in conjunction with diet is important for colorectal cancer prevention.

Adherence to the World Cancer Research Fund/American Institute for Cancer Research Recommendations and the Risk of Breast Cancer

“…We found similar results when using scores measuring overall adherence to the 2007 and 2018 guidelines, and our findings are largely in agreement with previous studies relying on recommendations from the earlier WCRF/AICR report. Along this line, recent findings on the association between the 2018 WCRF/AICR recommendation and colorectal cancer risk from the Nurses' Health Study and Health Professionals Follow-up Study confirmed the results of prior studies based on the 2007 guidelines release [47].…”

“…Only a few reports investigated the association between the 2018 release of the WCRF/AICR recommendations and cancer risk [42,[46][47][48]. The present study is the first evaluating the updated recommendations in the prevention of invasive breast cancer.…”

Association between the 2018 WCRF/AICR and the Low-Risk Lifestyle Scores with Colorectal Cancer Risk in the Predimed Study

“…In agreement with the results obtained, El Kinany and coworkers [16] found that greater adherence to the 2018 WCRF/AICR score decreased overall CRC risk by 42% after comparing 1516 cases with 1516 controls in Morocco. Similarly, a 24-year-follow-up cohort study [13], with 68,977 women from the Nurses' Health Study and 45,442 men from the Health Professionals Follow-up Study, found a statistically significant inverse association between adherence to the updated WCRF/AICR score and the incidence of CRC risk in men. Furthermore, associations in women were weaker.…”

“…Some prospective cohort studies [6,[8][9][10][11][12][13] and case-control studies [14][15][16] have evaluated the associations between CRC risk and adherence to cancer-specific nutritional recommendations with inconsistent results. However, limited longitudinal studies [13,16] have been conducted to assess associations based on the updated 2018 WCRF/AICR recommendations.…”

CHIP-mediated ubiquitination of Galectin-1 predicts colorectal cancer prognosis

“…With the ongoing societal and economic development, the incidence of CRC is becoming more and higher, especially in Asia countries with low incidence. In recent years, the incidence rate is close to the level of European and American countries [3,4].…”