Adherence to the WCRF/AICR Cancer Prevention Recommendations and All-Cause Mortality among Cancer Survivors from the Moli-sani Study Cohort †
by
, , , and
Claudia Francisca Martinez
1
,
Augusto Di Castelnuovo
2,
Simona Costanzo
1,
Emilia Ruggiero
1,
Giovanni de Gaetano
1,
Licia Iacoviello
3,* and
Marialaura Bonaccio
1 1
Department of Epidemiology and Prevention, IRCCS Neuromed, 86077 Pozzilli, Italy
2
Mediterranea Cardiocentro, 80122 Napoli, Italy
3
Department of Medicine and Surgery, LUM University “Giuseppe Degennaro”, 70010 Casamassima, Italy
*
Author to whom correspondence should be addressed.
†
Presented at the 14th European Nutrition Conference FENS 2023, Belgrade, Serbia, 14–17 November 2023.
Proceedings 2023, 91(1), 156; https://doi.org/10.3390/proceedings2023091156
Published: 1 February 2024
(This article belongs to the Proceedings of The 14th European Nutrition Conference FENS 2023)
Abstract
:Background and objectives: The guidelines provided by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) aim to reduce the risk of developing cancers worldwide. The WCRF/AICR advises cancer survivors to follow the same recommendations for cancer primary prevention. These recommendations have been operationalized into a quantitative index based on a total of seven or eight healthy lifestyles; the points-based system allows for scoring a full point and, in some cases, partially meeting a recommendation. Evidence of the usefulness of the WCRF/AICR recommendations in populations different from those in the US is scarce. The aim of the present study was to assess whether compliance with the 2018 WCRF/AICR recommendations for cancer prevention is related to all-cause mortality among cancer survivors recruited in the Moli-sani Study cohort in Italy (2005–2010). Methods: A longitudinal analysis of 786 participants (59.7% women) with a history of cancer at study entry were analyzed. The 2018 WCRF/AICR score included seven components: body weight, physical activity, plant-based foods, fast foods, red and processed meat, sugar-sweetened beverages, and alcohol; the optional breastfeeding component was excluded. The final score ranged between 0 and 7 points, with higher values reflecting greater alignment with the WCRF/AICR recommendations. Multivariable Cox proportional hazard models adjusted to account for sociodemographic factors and major health conditions were fitted for estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality. Results: The sample consisted of cancer survivors with an average age (SD) of 62.7 years old (11.7). Over a median follow-up of 11.8 years, a total of 220 deaths were registered. The median WCRF/AICR score was 4.6 ± SD 0.9. In multivariable-adjusted analyses, the risk of mortality was lower for participants who scored >5 points (HR = 0.54; 0.37–0.78; p value = 0.0010) compared to those who scored 0–4 points. Each one-point increment in the WCRF/AICR score was associated with a 22% decreased risk of all-cause mortality (HR = 0.78; 0.66–0.90; p value = 0.0012). Discussion: Higher compliance with the WCRF/AICR recommendations regarding diet, physical activity, and body weight was associated with lower all-cause mortality risk among cancer survivors. These findings suggest that cancer survivors should be encouraged to increase their adherence to the WCRF/AICR recommendations.
Author Contributions
C.F.M. and M.B. contributed to the conception, design, and interpretation of data; S.C. managed data collection; M.B., A.D.C. and E.R. analyzed the data; C.F.M. and M.B. wrote the original draft; G.d.G. and L.I. originally inspired the Moli-sani study and critically reviewed the draft. Full approval of the manuscript by all authors was completed. All authors have read and agreed to the published version of the manuscript.
Funding
This study has been performed in the context of the Fondazione Umberto Veronesi—IRCCS Neuromed framework agreement. The present analyses were partially supported by the Italian Ministry of Health (Ricerca Corrente 2022–2024). Funders had no role in any phase of the study or in the analysis and interpretation of findings, nor in the preparation of the manuscript or in the publication process. All authors were and are independent of funders.
Institutional Review Board Statement
The Moli-sani Study complies with the Declaration of Helsinki and was granted the approval of the Ethics Committee of the Catholic University in Rome, Italy, ID Prot. pdc. P.99 (A.931/03-138-04)/C.E./2004.
Informed Consent Statement
Written informed consent was obtained from all participants at study entry.
Data Availability Statement
The data underlying this article will be shared on reasonable request to the corresponding author.
Conflicts of Interest
The authors declare no conflict of interest.
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
MDPI and ACS Style
Martinez, C.F.; Di Castelnuovo, A.; Costanzo, S.; Ruggiero, E.; de Gaetano, G.; Iacoviello, L.; Bonaccio, M. Adherence to the WCRF/AICR Cancer Prevention Recommendations and All-Cause Mortality among Cancer Survivors from the Moli-sani Study Cohort. Proceedings 2023, 91, 156. https://doi.org/10.3390/proceedings2023091156
AMA Style
Martinez CF, Di Castelnuovo A, Costanzo S, Ruggiero E, de Gaetano G, Iacoviello L, Bonaccio M. Adherence to the WCRF/AICR Cancer Prevention Recommendations and All-Cause Mortality among Cancer Survivors from the Moli-sani Study Cohort. Proceedings. 2023; 91(1):156. https://doi.org/10.3390/proceedings2023091156
Chicago/Turabian StyleMartinez, Claudia Francisca, Augusto Di Castelnuovo, Simona Costanzo, Emilia Ruggiero, Giovanni de Gaetano, Licia Iacoviello, and Marialaura Bonaccio. 2023. "Adherence to the WCRF/AICR Cancer Prevention Recommendations and All-Cause Mortality among Cancer Survivors from the Moli-sani Study Cohort" Proceedings 91, no. 1: 156. https://doi.org/10.3390/proceedings2023091156
