Celis-Morales, Carlos

Ho, Frederick

Malcomson, Fiona C.

Mathers, John C.

Parra-Soto, Solange

Sharp, Linda

Background: The WCRF/AICR Cancer Prevention Recommendations are lifestyle-based guidelines which aim to reduce cancer risk. This study investigated, in the UK Biobank, associations between an abbreviated score to assess adherence to these Recommendations and the risk of all cancers combined and of 14 cancers for which there is strong evidence for links with diet, adiposity, and physical activity. Methods: We used data from 288,802 UK Biobank participants (mean age 56.2 years), cancer-free at baseline. An abbreviated version of the 2018 WCRF/AICR Score was calculated to assess adherence to five Recommendations on i) body weight, ii) physical activity, iii) fruits, vegetables and dietary fibre, iv) red and processed meat, and v) alcohol. Multivariable Cox proportional hazards models were used to analyse associations between the abbreviated score (range 0-5 points) and cancer incidence, adjusting for confounders. Results: During a median follow-up of 8.2 years (IQR 7.4-8.9), 23,448 participants were diagnosed with cancer. The abbreviated score was inversely associated with risk of cancer overall (HR:0.93; 95% CI:0.92-0.95 per 1-point increment), and breast (HR:0.90; 95% CI:0.87–0.94), colorectal (HR:0.86; 95% CI: 0.83–0.90), lung (HR:0.89; 95% CI:0.84-0.94), kidney (HR:0.83; 95% CI:0.76-0.90), pancreatic (HR:0.86; 95% CI: 0.79-0.94), uterine (HR:0.79; 95% CI: 0.73-0.86), oesophageal (HR:0.82; 95% CI: 0.75-0.90), stomach (HR:0.89; 95% CI: 0.79-0.99), and liver (HR:0.80; 95% CI:0.72–0.90) cancers. Conclusions: Greater adherence to the Cancer Prevention Recommendations, assessed using an abbreviated score, was associated with reduced risk of all cancers combined and of nine site-specific cancers. Impact: Our findings support compliance to these Recommendations for cancer prevention

Abbreviated score to assess adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and risk of cancer in the UK Biobank

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