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Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention guidelines and colorectal cancer incidence among African Americans and whites: The Atherosclerosis Risk in Communities study.

TitleAdherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention guidelines and colorectal cancer incidence among African Americans and whites: The Atherosclerosis Risk in Communities study.
Publication TypeJournal Article
Year of Publication2020
AuthorsOnyeaghala G, Lintelmann AK, Joshu CE, Lutsey PL, Folsom AR, Robien K, Platz EA
Secondary AuthorsPrizment AE
JournalCancer
Volume126
Issue5
Pagination1041-1050
Date Published2020 03 01
ISSN1097-0142
KeywordsAfrican Americans, Colorectal Neoplasms, Diet, European Continental Ancestry Group, Female, Follow-Up Studies, Guidelines as Topic, Humans, Incidence, Life Style, Male, Middle Aged, Patient Compliance, Prognosis, Prospective Studies, Risk Factors, Surveys and Questionnaires, United States
Abstract

BACKGROUND: Adherence to the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) cancer prevention recommendations is associated with colorectal cancer (CRC) risk in whites, but only 1 previous study has reported on this link in African Americans. This study assessed the association between the 2018 WCRF/AICR guidelines and CRC incidence in African Americans (26.5%) and whites (73.5%) in the Atherosclerosis Risk in Communities prospective cohort (n = 13,822).

METHODS: A total of 368 incident CRC cases (268 among whites and 100 among African Americans) were identified between the baseline (1987) and 2012. A baseline adherence score was created for 7 WCRF/AICR guidelines (each contributing 0, 0.5, or 1 point to the score, with higher scores corresponding to greater adherence). Adherence scores were also categorized as tertiles (0.0-3.0, 3.5-4.0, and 4.5-7.0). Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the total cohort and with stratification by race.

RESULTS: After adjustments for age, sex, race, center, smoking, education, intake of aspirin, calcium, total calories, diabetes status, and, in women, hormone replacement therapy, greater adherence was associated with decreased CRC risk. The HRs per 1-unit increment in score were 0.88 (95% CI, 0.80-0.97) for the whole cohort, 0.89 (95% CI, 0.73-1.09) for African Americans, and 0.88 (95% CI, 0.77-0.99) for whites. Similar associations between higher adherence scores and decreased cancer risk were observed for men and women and for colon cancer but not for rectal cancer.

CONCLUSIONS: Greater adherence to the cancer prevention recommendations appears to be associated with decreased CRC risk for both African Americans and whites.

DOI10.1002/cncr.32616
Alternate JournalCancer
PubMed ID31873947
PubMed Central IDPMC7021569
Grant ListP30 CA006973 / CA / NCI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
U01 CA164975 / CA / NCI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States