Impact of adherence to cancer-specific prevention recommendations on subsequent risk of cancer in participants in Alberta’s Tomorrow Project

OBJECTIVE: The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) publish recommendations for cancer prevention. The present study aimed to estimate the association between adherence to these cancer-specific prevention recommendations and subsequent development of cancer in a prospective cohort. DESIGN: A composite adherence score was constructed based on questionnaire data to reflect overall adherence to WCRF/AICR lifestyle-related recommendations on body fatness, physical activity, diet and alcoholic drinks. Multivariable Cox proportional hazard regression models were used to assess the association (hazard ratio; 95 % CI) between the adherence score and risk of developing cancer. SETTING: Alberta’s Tomorrow Project, a prospective cohort study. PARTICIPANTS: Men and women (n 25 100, mean age at enrolment 50·5 years) recruited between 2001 and 2009 with no previous cancer diagnosis were included in analyses. RESULTS: Cancer cases (n 2066) were identified during a mean follow-up of 11·7 years. Participants who were most adherent to the selected WCRF/AICR recommendations (composite score: 4–6) were 13 % (0·87; 0·78, 0·98) less likely to develop cancer compared with those who were least adherent (composite score: 0–2). Each additional recommendation met corresponded to a 5 % (0·95; 0·91, 0·99) reduction in risk of developing cancer. When stratified by sex, the associations remained significant for women, but not for men. CONCLUSIONS: Adherence to lifestyle-related cancer prevention recommendations was associated with reduced risk of developing cancer over the follow-up term in this Canadian cohort.