Adherence to the World Cancer Research Fund/American Institute for Cancer Research Guideline Is Associated With Better Health-Related Quality of Life Among Chinese Patients With Breast Cancer.

The 2007 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guideline provides recommendations for cancer prevention among cancer survivors. Limited data have examined whether guideline adherence is related to health-related quality of life (HRQoL) among Chinese patients with breast cancer. An ongoing prospective cohort study involving 1,462 Chinese women with early-stage breast cancer assessed exercise, diet, and body mass index (BMI) at baseline and at 18-months follow-up after diagnosis. Each assessment recorded patient habits within the previous 12 months. HRQoL was evaluated by the EORTC Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). We first compared the level of adherence to WCRF/AICR recommendations before and after cancer diagnosis. We then examined whether adherence to these recommendations after diagnosis was associated with HRQoL at 18 months. The mean adherence score significantly increased from baseline (3.2; SD, 1.1) to 18-month follow-up (3.9; SD, 1.1; <.001). Overall, increasing adherence to the WCRF/AICR guideline was associated with higher scores of global health status/quality of life (QoL; =.011), physical (<.001) and role functioning (=.024), and lower scores for fatigue (=.016), nausea and vomiting (<.001), pain (=.004), dyspnea (=.030), loss of appetite (=.007), and diarrhea (=.020). Patients with cancer who met the BMI recommendation had higher scores for physical functioning (=.001) and lower scores for fatigue (=.024), pain (<.001), and dyspnea (=.045). Adherence to physical activity recommendation was associated with better scores of global health status/QoL (<.001), physical functioning (=.003), fatigue (=.002), pain (=.018), and dyspnea (=.021). Higher adherence to diet recommendation was associated with lower scores of nausea and vomiting (=.005), loss of appetite (=.026), constipation (=.040), and diarrhea (=.031). Chinese patients with breast cancer made positive lifestyle changes early after cancer diagnosis. Increased adherence to WCRF/AICR recommendations after cancer diagnosis may improve HRQoL. Our data suggest that Chinese patients with breast cancer should follow the WCRF/AICR guideline to improve overall well-being.