New Data Shows that Following Our Cancer Prevention Recommendations Reduces Overall Risk of Death

A major new study has found that cancer survivors who were more closely following the WCRF/AICR Cancer Prevention Recommendations were less likely to die from any cause.

This important work was funded by Wereld Kanker Onderzoek Fonds (WKOF), the Netherlands-based charity within the World Cancer Research Fund International network of charities, which also includes the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR).

The research was led by Professor John Mathers, Professor Linda Sharp, and Dr. Fiona Malcomson at Newcastle University, UK.

Dr. Malcomson, an expert in human nutrition, is also a scientific advisor to AICR. She says

“the WCRF/AICR Cancer Prevention Recommendations include lifestyle-based advice such as ‘be physically active’ and ‘eat a diet rich in whole grains, vegetables, fruits and beans. These recommendations are used extensively for cancer prevention, and it is also advised for them to be followed by those living with and beyond cancer, if they can.”

Malcomson explains that while previous research has suggested that these recommendations have a role to play in survivorship, this study is the first of its kind, in a UK cohort, to show just how significant these lifestyle factors can be for people diagnosed with cancer.

The WCRF/AICR Recommendations, which were published in 2018 based on decades of evidence, are now benefiting research and people around the world. As the number of cancer survivors is increasing worldwide, these findings could help cancer survivors stay healthy.

Gathering Data on Lifestyle Factors

The team of scientists used data from the UK Biobank, which is a large cohort study that recruited over half a million participants across the UK between 2006 and 2010.

“Our study included 28,550 participants who were diagnosed with a single cancer after joining the UK Biobank cohort,” says Dr. Malcomson. “We assessed how closely the Cancer Prevention Recommendations were followed at the time of recruitment to the UK Biobank, prior to a cancer diagnosis, using dietary and other lifestyle data such as body weight and how much physical activity participants reported doing.”

The scientists used a scoring system that included the following five recommendations:

1. Be a healthy weight
2. Be physically active
3. Eat whole grains, vegetables, fruit and beans
4. Limit red and processed meat
5. Limit alcohol consumption

Points were assigned for fully meeting, partly meeting, or not meeting each recommendation, and a total score ranging from 0-5 points was calculated for each participant. Higher total scores represented greater alignment with the Cancer Prevention Recommendations, indicating a healthier lifestyle.

Breaking Down the Results

Through their analysis, the team concluded that each 1-point increase in total score, equivalent to fully meeting one recommendation, was associated with an 8% lower risk of all-cause mortality (the chance of dying from any cause over time).

“We divided the study population into thirds according to their total scores, from lowest to highest, and found that participants in the highest third (who scored between 3.25 and 5 points) had a 16 percent lower chance of dying from any cause compared with those in the lowest third (who scored up to 2 points),” says Dr. Malcomson.

The same associations were observed regardless of whether people smoked or not, and whether cancer was diagnosed within six years of joining the study or later.

“We also ran several additional analyses to test whether the associations were consistent in different groups of cancer survivors,” she adds. “For example, similar findings were observed in participants diagnosed with one or more cancer(s) and in those who already had a cancer diagnosis when they joined the UK Biobank study.”

When the research team dug deeper into the 14 specific cancer sites that the participants were diagnosed with, they found that each 1-point increase in total score was associated with:

• 14% lower risk of all-cause mortality in participants with liver cancer
• 11% lower risk of all-cause mortality in participants diagnosed with esophageal cancer
• 8% lower risk of all-cause mortality in men diagnosed with prostate cancer
• 6% lower risk of all-cause mortality in women diagnosed with breast cancer
• 5% lower risk of all-cause mortality in lung cancer survivors
• And a trend for 5% lower risk of all-cause mortality in colorectal cancer survivors

Future Interventions for Healthy Living

The findings show that following a healthy lifestyle is important for cancer prevention and may also have implications for long-term health after a cancer diagnosis. The research team suggest that these findings support prioritizing the development of interventions to enhance adherence to the WCRF/AICR Cancer Prevention Recommendations, which may potentially lower mortality risk among people diagnosed with cancer.

This is the first study worldwide to report associations between following the 2018 WCRF/AICR Cancer Prevention Recommendations and lower chance of death overall in individuals living with and beyond prostate, lung, esophageal and liver cancers.

“The take home message is that the 2018 WCRF/AICR Cancer Prevention Recommendations apply to cancer survivors too,” says Dr. Malcomson. “Having a healthier eating pattern, being more physically active and avoiding being too heavy, as described in the Recommendations, is associated with better long-term outcomes for those living with and beyond cancer. This means that cancer survivors can take action to improve their health and should be encouraged to do so by their healthcare providers.”