Greater adherence to lifestyle recommendations associated with lower cancer risk

Greater adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations—which encourage a healthy lifestyle—is associated with a lower risk of all cancers combined and some individual cancers such as breast cancer. The findings are published in BMC Medicine.

The 2018 WCRF/AICR cancer prevention recommendations aim to reduce the risk of cancer by encouraging individuals to maintain a healthy weight, be physically active, and eat a diet rich in wholegrains, vegetables, fruit, and beans, but low in highly processed foods, red and processed meat, sugar-sweetened drinks, and alcohol.

John Mathers and colleagues investigated the relationship between adherence to the WCRF/AICR recommendations and cancer risk by analyzing UK Biobank data for 94,778 British adults, who were 56 years old on average.

The researchers used self-reported dietary and physical activity data—in addition to participants' body mass index and waist circumference measurements—to score participants' adherence to the recommendations out of a maximum score of 7 points. They used cancer registry data to calculate the incidence of new cancers that developed over an average period of 8 years.

They accounted for age, sex, socioeconomic deprivation, ethnicity, and smoking status in their analyses. The average recommendation adherence score was 3.8 points and 7,296 participants (8%) developed cancer during the study period.

The authors found that greater adherence to the WCRF/AICR recommendations was associated with a lower risk of all cancers combined, with each 1-point increase in recommendation adherence score associated with a 7% lower risk. Compared to those with adherence scores of 3.5 points or less, those with a score of 4.5 points or above had a 16% lower risk of all cancers combined.

They also found that each 1-point increase in adherence score was associated with a 10% lower risk of breast cancer, a 10% lower risk of colorectal cancer, an 18% lower risk of kidney cancer, a 16% lower risk of esophageal cancer, a 22% lower risk of liver cancer, a 24% lower risk of ovarian cancer, and a 30% lower risk of gallbladder cancer.

The findings support compliance with the WCRF/AICR recommendations for cancer prevention in the UK, but the authors note that the observational nature of their study does not allow for conclusions about a causal relationship between WCRF/AICR recommendation adherence and cancer risk.

The authors add that further research is needed to investigate which recommendations may be driving the observed association between recommendation adherence and cancer risk.