Health Promotion Sciences, Canyon Ranch Center for Prevention & Health Promotion, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Street, Tucson, AZ 85721.
Cancer Prev Res (Phila). 2014 Jan;7(1):42-53. doi: 10.1158/1940-6207.CAPR-13-0258.
Healthy lifestyle behaviors are recommended to reduce cancer risk and overall mortality. Adherence to cancer-preventive health behaviors and subsequent cancer risk has not been evaluated in a diverse sample of postmenopausal women. We examined the association between the American Cancer Society (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines score and risk of incident cancer, cancer-specific mortality, and all-cause mortality in 65,838 postmenopausal women enrolled in the Women's Health Initiative Observational Study. ACS guidelines scores (0-8 points) were determined from a combined measure of diet, physical activity, body mass index (current and at age 18 years), and alcohol consumption. After a mean follow-up of 12.6 years, 8,632 incident cancers and 2,356 cancer deaths were identified. The highest ACS guidelines scores compared with the lowest were associated with a 17% lower risk of any cancer [HR, 0.83; 95% confidence interval (CI), 0.75-0.92], 22% lower risk of breast cancer (HR, 0.78; 95% CI, 0.67-0.92), 52% lower risk of colorectal cancer (HR, 0.48; 95% CI, 0.32-0.73), 27% lower risk of all-cause mortality, and 20% lower risk of cancer-specific mortality (HR, 0.80; 95% CI, 0.71-0.90). Associations with lower cancer incidence and mortality were generally strongest among Asian, black, and Hispanic women and weakest among non-Hispanic whites. Behaviors concordant with Nutrition and Physical Activity Cancer Prevention Guidelines were associated with lower risk of total, breast, and colorectal cancers and lower cancer-specific mortality in postmenopausal women.
健康的生活方式行为被推荐用于降低癌症风险和总体死亡率。在绝经后妇女的多样化样本中，尚未评估预防癌症的健康行为的依从性及其随后的癌症风险。我们研究了美国癌症协会 (ACS) 营养和体育活动癌症预防指南评分与 65838 名参加妇女健康倡议观察研究的绝经后妇女的癌症发病风险、癌症特异性死亡率和全因死亡率之间的关系。ACS 指南评分（0-8 分）是通过饮食、体育活动、体重指数（当前和 18 岁时）和饮酒量的综合测量来确定的。在平均 12.6 年的随访后，发现了 8632 例新发癌症和 2356 例癌症死亡。与最低评分相比，最高评分与任何癌症风险降低 17%相关[风险比 (HR)，0.83；95%置信区间 (CI)，0.75-0.92]、乳腺癌风险降低 22%（HR，0.78；95% CI，0.67-0.92）、结直肠癌风险降低 52%（HR，0.48；95% CI，0.32-0.73）、全因死亡率降低 27%和癌症特异性死亡率降低 20%（HR，0.80；95% CI，0.71-0.90）。在亚洲、黑人、西班牙裔妇女中，与较低癌症发病率和死亡率相关的关联通常最强，而在非西班牙裔白人中则最弱。与营养和体育活动癌症预防指南一致的行为与绝经后妇女的总癌症、乳腺癌和结直肠癌发病率降低以及癌症特异性死亡率降低相关。
