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Adherence to the AICR Cancer Prevention Recommendations and Subsequent Morbidity and Mortality in the Iowa Women's Health Study Cohort
In 1997, the American Institute for Cancer Research (AICR) published 14 recommendations related to diet for individuals to reduce cancer incidence on a global basis; smoking was also discouraged. We operationalized these into nine recommendations that are particularly relevant to western populations...
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Published in: | Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 2004-07, Vol.13 (7), p.1114-1120 |
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Main Authors: | , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | In 1997, the American Institute for Cancer Research (AICR) published 14 recommendations related to diet for individuals to
reduce cancer incidence on a global basis; smoking was also discouraged. We operationalized these into nine recommendations
that are particularly relevant to western populations in a cohort of 29,564 women ages 55 to 69 years at baseline in 1986
who had no history of cancer or heart disease. The cohort was followed through 1998 for cancer incidence ( n = 4,379), cancer mortality ( n = 1,434), cardiovascular disease (CVD) mortality ( n = 1,124), and total mortality ( n = 3,398). The median number (range) of recommendations followed was 4 (0-8), and 33% of the cohort had ever smoked. Women
who followed no or one recommendation compared with six to nine recommendations were at an increased risk of cancer incidence
[relative risk (RR) 1.35, 95% confidence interval (CI) 1.15-1.58] and cancer mortality (RR 1.43, 95% CI 1.11-1.85), but there
was no association with CVD mortality (RR 1.06, 95% CI 0.78-1.43). We calculated the population attributable risk (PAR) to
estimate the proportion of cancer incidence, cancer mortality, and CVD mortality that theoretically would have been avoidable
if the entire cohort had never smoked, had followed six to nine recommendations, or had done both. The PARs for smoking were
11% (95% CI 10-13) for cancer incidence, 21% (95% CI 17-24) for cancer mortality, and 20% (95% CI 16-23) for CVD mortality.
The PARs for not following six to nine recommendations were 22% (95% CI 12-30) for cancer incidence, 11% (95% CI −5 to 24)
for cancer mortality, and 4% (95% CI −20 to 19) for CVD mortality. When smoking and the operationalized AICR recommendations
were combined together, the PARs were 31% (95% CI 19-37) for cancer incidence, 30% (95% CI 15-40) for cancer mortality, and
22% (95% CI 4-36) for CVD mortality. These data suggest that the adherence to the AICR recommendations, independently and
in conjunction with not smoking, is likely to have a substantial public health impact on reducing cancer incidence and, to
a lesser degree, cancer mortality at the population level. |
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ISSN: | 1055-9965 1538-7755 |
DOI: | 10.1158/1055-9965.1114.13.7 |