Highlights
- •A pooled analysis of 2 Italian studies with 2419 CRC cases and 4723 controls.
- •The role of adherence to the WCRF/AICR guidelines on CRC was evaluated.
- •Adherence to the guidelines was summarised through a score based on 7 recommendations.
- •The WCRF/AICR score was significantly inversely related to CRC risk.
- •Higher adherence to the WCRF/AICR guidelines was associated to a 30% reduced CRC risk.
Abstract
Background
The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research
(AICR) released in 2007 eight recommendations for cancer prevention on body fatness,
diet and physical activity. Our aim is to evaluate the relation between adherence
to these recommendations and colorectal cancer (CRC) risk.
Methods
We pooled data from two Italian case–control studies including overall 2419 patients
with CRC and 4723 controls. Adherence to the WCRF/AICR guidelines was summarised through
a score incorporating seven of the WCRF/AICR recommendations, with higher scores indicating
higher adherence to the guidelines. Odds ratios (ORs) of colorectal cancer were estimated
using multiple logistic regression models.
Results
Higher adherence to the WCRF/AICR recommendations was associated with a significantly
reduced CRC risk (OR 0.67, 95% confidence interval, CI, 0.56–0.80 for a score ≥5 versus
<3.5), with a significant trend of decreasing risk for increasing adherence (p < 0.001).
Consistent results were found for colon (OR 0.67) and rectal cancer (OR 0.67). Inverse
associations were observed with the diet-specific WCRF/AICR score (OR 0.71, 95% CI,
0.61–0.84 for ≥3.5 versus <2.5 points) and with specific recommendations on body fatness
(OR 0.82, 95% CI, 0.70–0.97), physical activity (OR 0.86, 95% CI, 0.75–1.00), foods
and drinks that promote weight gain (OR 0.70, 95% CI, 0.56–0.89), foods of plant origin
(OR 0.56, 95% CI, 0.42–0.76), limiting alcohol (OR 0.87, 95% CI, 0.77–0.99) and salt
intake (OR 0.63, 95% CI, 0.48–0.84).
Conclusion
Our study indicated that adherence to the WCRF/AICR recommendations is inversely related
to CRC risk.
Keywords
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Article info
Publication history
Published online: September 08, 2017
Accepted:
August 7,
2017
Received in revised form:
July 26,
2017
Received:
May 19,
2017
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
