Association between Cancer Risk and Behaviors Adherent to Cancer Prevention Recommendations in Ontario, Canada

In 2007, the World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) published several diet and physical activity recommendations to reduce cancer risk. Our objective was to examine the association between self-reported behaviors consistent with the WCRF/AICR recommendations and the risk of developing any cancer and colorectal cancer in Ontario.

111,139 Ontarians who completed the Canadian Community Health Survey (2000-2008) were linked to the Ontario Cancer Registry to determine whether they were diagnosed with cancer. Their responses were used to assess behaviors consistent with 4 WCRF/AICR recommendations (body fatness, physical activity, vegetable and fruit consumption, and alcoholic drinks). Multivariate Cox proportional hazard regression models were used to assess the association between adherence to the 4 WCRF/AICR recommendations and subsequent cancer risk.

Among the 111,139 participants, 8,942 (8%) were diagnosed with cancer with a mean follow-up of 9.6 years. Compared to not meeting any of the selected WCRF/AICR recommendations (composite score, 0), participants who were most adherent to the selected WCRF/AICR recommendations (composite score, 4) were 31% less likely to develop any cancer (HR, 0.69; 95% CI, 0.51-0.92) and were 61% less likely to develop colorectal cancer (HR, 0.39; 95% CI, 0.20-0.77) after adjusting for some potential confounding factors. When stratified by sex, the associations remained statistically significant for men, but not for women. In addition, increasing vegetable and fruit consumption, having lower body fatness, and decreasing alcohol consumption were each associated with reduced risk of both any cancer and colorectal cancer.

Healthy behaviors consistent with select WCRF/AICR recommendations were associated with a decreased risk of developing any cancer and colorectal cancer among this Ontario cohort.