Abstract
BACKGROUND: The 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations aim to lower cancer incidence. Our study explored associations between adherence to these Recommendations and the risk of first cancer incidence in a US cohort. METHODS: Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Study participants who were cancer-free at baseline and who had height, weight, physical activity, diet, and alcohol data to estimate the standardized 2018 WCRF/AICR Score (n = 69,061) were included. Associations between Score and cancer endpoints, including any cancers, any of the 17 WCRF/AICR-reviewed cancers, and individual cancer sites were investigated using multivariable Cox proportional hazard models, adjusting for covariates. RESULTS: Mean Score was 3.55 points (range 0-7). During a median follow-up of 10 years, 11,109 participants developed cancer. The 2018 WCRF/AICR Score was significantly inversely associated with risk of any cancers (HR per 1-point increment:0.97; 95% CI: 0.95-0.99), any of the 17 WCRF/AICR-reviewed cancers (HR: 0.97; 95% CI: 0.95-0.99), pancreatic (HR:0.86; 95% CI: 0.78-0.96), and breast (HR:0.91; 95% CI: 0.87-0.96) cancers. DISCUSSION: Our findings support adherence to the WCRF/AICR Cancer Prevention Recommendations for reducing risk of cancer incidence, particularly breast and pancreatic cancers, in the US. CLINICAL REGISTRATION NUMBERS: The PLCO Cancer Screening Trial is registered with ClinicalTrials.gov: NCT00002540 (Prostate), NCT01696968 (Lung), NCT01696981 (Colorectal), NCT01696994 (Ovarian), and NCT00339495 (EEMS).