Abstract
Background: Following the publication of the 2018 World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) Third Expert Report, a collaborative group was formed to develop a standardized scoring system and provide guidance for research applications. Methods: The 2018 WCRF/AICR Cancer Prevention Recommendations, goals, and statements of advice were examined to define components of the new Score. Cut-points for scoring were based on quantitative guidance in the 2018 Recommendations and other guidelines, past research that operationalized 2007 WCRF/AICR Recommendations, and advice from the Continuous Update Project Expert Panel. Results: Eight of the ten 2018 WCRF/AICR Recommendations concerning weight, physical activity, diet, and breastfeeding (optional), were selected for inclusion. Each component is worth one point: 1, 0.5, and 0 points for fully, partially, and not meeting each recommendation, respectively (Score: 0 to 7–8 points). Two recommendations on dietary supplement use and for cancer survivors are not included due to operational redundancy. Additional guidance stresses the importance of accounting for other risk factors (e.g., smoking) in relevant models. Conclusions: The proposed 2018 WCRF/AICR Score is a practical tool for researchers to examine how adherence to the 2018 WCRF/AICR Recommendations relates to cancer risk and mortality in various adult populations.
Highlights
In 2018, the World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) published Diet, Nutrition, Physical Activity, and Cancer: A Global Perspective, the WCRF/AICRThird Expert Report [1]
Panagiota Mitrou), and ISGlobal (Dora Romaguera), the latter of whom was involved in the development of the first reported adherence score based on the 2007 WCRF/AICR Cancer Prevention
We modelled the cut-points for partially and not meeting these recommendations on the consensus of scores based on the 2007 WCRF/AICR Recommendations, due to evidence supporting that meeting at least half of each recommendation is associated with health benefits [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21]
Summary
In 2018, the World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) published Diet, Nutrition, Physical Activity, and Cancer: A Global Perspective, the WCRF/AICR. Given that an estimated 30–50% of all cancer cases are preventable, this report underpinned the updated ten Cancer Prevention Recommendations that set the benchmark for evidence-based guidance, including eating a healthy diet, maintaining a healthy body weight, and engaging in regular physical activity [1]. Continuous Update Project (CUP) Expert Panel, who authored the Recommendations, was that each recommendation was intended to be one part of a comprehensive package of modifiable lifestyle behaviors that, when taken together, promote a healthy pattern of diet and physical activity conducive to the prevention of cancer, other non-communicable diseases, and obesity. American Institute for Cancer Research (AICR) Third Expert Report, a collaborative group was formed to develop a standardized scoring system and provide guidance for research applications
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