Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Br J Cancer. 2023 Oct;129(6):982-992. doi: 10.1038/s41416-023-02314-x. Epub 2023 Jul 27.
The standardized scoring system assessing adherence to the 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) cancer prevention recommendations assigns equal weight for each recommendation, thereby giving higher weight to dietary factors collectively (5 points) than adiposity (1 point) and physical activity (1 point). An alternative score assigning equal weights to the adiposity, physical activity, alcohol, and other dietary (composite) recommendations may better predict cancer associations.
We examined associations between standardized and alternative scores with cancer risk in two US prospective cohorts. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox regression.
During 28 years of follow-up, 16,342 incident cancer cases in women and 8729 cases in men occurred. Individuals in the highest versus lowest quintile of the standardized score had a reduced overall cancer risk (women: HR = 0.89, 95% CI: 0.85, 0.94; men: HR = 0.87, 95% CI: 0.81, 0.94). Results were slightly stronger for the alternative score (women: HR = 0.83, 95% CI: 0.79, 0.87; men: HR = 0.81, 95% CI: 0.75, 0.86). Similar patterns were observed for obesity-related, alcohol-related, smoking-related, and digestive system cancers.
Greater adherence to the WCRF/AICR cancer prevention recommendations was associated with lower cancer risk. A score assigning equal weights to the adiposity, physical activity, alcohol, and all remaining diet components yielded stronger associations than the standardized score.
评估对 2018 年世界癌症研究基金会（WCRF）/美国癌症研究所（AICR）癌症预防建议的依从性的标准化评分系统为每个建议赋予相同的权重，从而使饮食因素的权重（5 分）高于肥胖（1 分）和体力活动（1 分）。为肥胖、体力活动、酒精和其他饮食（综合）建议分配相等权重的替代评分可能更好地预测癌症相关性。
我们在美国的两个前瞻性队列中研究了标准化评分和替代评分与癌症风险之间的关系。使用 Cox 回归计算多变量调整后的风险比（HR）和 95%置信区间（CI）。
在 28 年的随访期间，女性发生了 16342 例、男性发生了 8729 例新癌症病例。标准化评分最高五分位数与最低五分位数的个体整体癌症风险降低（女性：HR=0.89，95%CI：0.85，0.94；男性：HR=0.87，95%CI：0.81，0.94）。替代评分的结果略强（女性：HR=0.83，95%CI：0.79，0.87；男性：HR=0.81，95%CI：0.75，0.86）。对于肥胖相关癌症、酒精相关癌症、吸烟相关癌症和消化系统癌症，也观察到类似的模式。
对 WCRF/AICR 癌症预防建议的依从性越高，癌症风险越低。为肥胖、体力活动、酒精和所有剩余饮食成分分配相等权重的评分比标准化评分产生更强的相关性。
