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The 2018 World Cancer Research Fund/American Institute for Cancer Research Score and Cancer Risk: results from the
Ashley H Tjaden1, Audrey A Goldbaum2, Sharon L Edelstein1
1Biostatistics Center, Milken Institute of Public Health, George Washington University, Rockville, MD, United States.
The American Journal of Clinical Nutrition
|July 17, 2025
Summary
Improving adherence to lifestyle recommendations can significantly lower cancer risk in adults with prediabetes. This study highlights the importance of lifestyle modifications for cancer prevention in at-risk populations.
Area of Science:
- Lifestyle medicine
- Cancer prevention research
- Diabetes and metabolic health
Background:
- Modifying lifestyle factors is crucial for reducing the incidence of obesity, diabetes, and cancer.
- The Diabetes Prevention Program (DPP) and its observational follow-up, the DPP Outcomes Study (DPPOS), provide a unique cohort for studying long-term health outcomes.
- Understanding the impact of lifestyle recommendations on cancer risk in individuals with prediabetes is essential for public health.
Purpose of the Study:
- To examine the association between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations and incident lifestyle-related cancer.
- To assess this association in adults with prediabetes participating in the DPP and DPPOS studies.
- To evaluate the impact of baseline adherence and changes in adherence over time on cancer risk.
Main Methods:
- Utilized data from the Diabetes Prevention Program (DPP) and DPP Outcomes Study (DPPOS), including participants randomized to lifestyle, metformin, or placebo interventions.
- Calculated the 2018 WCRF/AICR score (0-7 points) based on body weight, physical activity, diet, and alcohol intake at multiple time points.
- Employed adjusted Cox proportional hazard models to analyze the association between the WCRF/AICR score (baseline, change from 0-1 year, time-dependent) and incident lifestyle-related cancer.
Main Results:
- The mean baseline WCRF/AICR score was 3.2, with scores improving over time.
- While baseline adherence was not associated with cancer risk, a 1-unit improvement in the score from baseline to 1 year was linked to a 14% lower risk.
- Time-dependent adherence also showed a significant association with a 9% lower risk of lifestyle-related cancer, irrespective of intervention group or diabetes status.
Conclusions:
- Adherence to WCRF/AICR recommendations may reduce cancer risk in adults with prediabetes and type 2 diabetes.
- This study underscores the critical role of lifestyle interventions in comprehensive cancer prevention strategies.
- The findings emphasize the long-term benefits of sustained lifestyle modifications for individuals at risk of chronic diseases.
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