Reduction in Breast Cancer Risk Associated with Meeting the WCRF/AICR Cancer Prevention Recommendations

Abstract

Abstract In 2007 the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) published eight recommendations related to body weight, physical activity and dietary behaviors aimed at reducing cancer incidence worldwide. These were based on a comprehensive review of the literature on these topics in relation to each of the common cancers. An expert panel operationalized seven of those recommendations (maintaining normal body weight, participating in moderate physical activity for at least 30 minutes per day, avoiding energy-dense foods, eating 5 or more servings of non-starchy fruits and vegetables per day, limiting consumption of red meat to no more than 18 oz per week, limiting alcohol consumption to one drink per day for women and two drinks per day for men, and limiting sodium consumption to 2400 mg per day), and we examined their association with breast cancer incidence over eight years of follow-up in the VITamins And Lifestyle (VITAL) Study cohort. Participants included 24,916 women aged 50–76 years at baseline in 2000–2002 who had no history of cancer and who had complete data for the recommendations evaluated. Incident cancers (n = 694) were tracked through the Western Washington Surveillance, Epidemiology and End Results (SEER) database. The median number of recommendations followed was 3 (0–7). After adjusting for age, education, race/ethnicity, mammogram in previous two years, history of breast cancer in a first-degree relative, years of combined estrogen plus progestin hormone therapy use, age at menarche, age at first birth, and age at menopause, the hazard ratios and 95% confidence intervals associated with meeting 1, 2, 3, 4, 5, and 6–7 recommendations compared with meeting none of the recommendations were: 0.57 (0.35, 0.95), 0.63 (0.39, 1.02), 0.55 (0.34, 0.88), 0.46 (0.28, 0.74), 0.44 (0.26, 0.75), and 0.31 (0.15, 0.65). These results suggest that meeting the WCRF/AICR recommendations could substantially decrease breast cancer risk.