ASPO Abstracts

Adherence to WCRF/AICR cancer prevention guidelines and cancer outcomes: A systematic review and meta-analysis

Authors: Lee E, Figueroa A, Durham N, López Castillo H

Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2020

Abstract Body:
Purpose: The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) publishes cancer prevention guidelines to reduce cancer risk in healthy people and to minimize health risks in cancer survivors. However, few studies examined whether the impact of adhering to these guidelines on mortality is the same as on cancer incidence and whether there is an effect modification by cancer type. Methods: Web of Sciences and EBSCOhost (including Medline and CINHAL) were searched up to December 2018 for relevant publications using the key search terms. The search was limited to studies published in English, with publication date from 1997, and original articles published in peer-reviewed journals. Data extraction was performed using DistillerSR software. The study characteristics, participants, recommendations, and summary effect sizes were estimated for cancer incidence and mortality overall and by cancer types. Meta-analysis was conducted using random-effects models Results: Thirty-five articles among the 176 initially identified were eligible for full-text review, and 25 (18 cohort studies and 7 case-control studies) were included in data extraction. Meta-analysis showed that adhering to one additional WCRF/AICR recommendations could reduce overall cancer incidence and mortality by 10% (RR 0.90, 95%CI 0.88–0.92). Subgroup analysis for cancer incidence showed that the strength of the association varied by cancer types with head and neck cancer having the highest impact (RR 0.60, 95%CI 0.55-0.65) and prostate cancer having the lowest, nonsignificant impact (RR 0.97 95% CI 0.93-1.01). For mortality, stomach cancer had the highest impact (RR 0.71 95%CI 0.54-0.93) with urinary tract cancer having the lowest, nonsignificant impact (RR 0.99, 95%CI 0.78-1.26). Additionally, higher adherence was associated with 27% reduced risks for cancer incidence and mortality (RR 0.73 95% CI 0.68-0.79; RR 0.73 95% CI 0.68-0.78, respectively) compared to lower adherence. Conclusions: Adhering to WCRF/AICR cancer prevention guidelines has the same effect on cancer incidence and mortality. Healthcare providers can encourage cancer survivors to comply with cancer prevention guidelines to improve their survival.

Keywords: WCRF/AICR recommendations, cancer incidence, mortality, systematic reviews, meta- analysis