Federica Turati1, Francesca Bravi2, Matteo Di Maso3, Cristina Bosetti4, Jerry Polesel5, Diego Serraino6, Michela Dalmartello7, Attilio Giacosa8, Maurizio Montella9, Alessandra Tavani10, Eva Negri11, Carlo La Vecchia12. 1. Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Via A. Vanzetti, 5, 20133 Milan, Italy. Electronic address: federica.turati@unimi.it. 2. Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Via A. Vanzetti, 5, 20133 Milan, Italy. Electronic address: francesca.bravi@unimi.it. 3. Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Via A. Vanzetti, 5, 20133 Milan, Italy. Electronic address: matteo.dimaso@unimi.it. 4. Department of Oncology, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Via G. La Masa 19, 20156 Milan, Italy. Electronic address: cristina.bosetti@marionegri.it. 5. Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, IRCCS, Via F. Gallini 2, 33080 Aviano, Italy. Electronic address: polesel@cro.it. 6. Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, IRCCS, Via F. Gallini 2, 33080 Aviano, Italy. Electronic address: serrainod@cro.it. 7. Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Via A. Vanzetti, 5, 20133 Milan, Italy. Electronic address: michela.dalmartello@unimi.it. 8. Department of Gastroenterology and Clinical Nutrition, Policlinico di Monza, Via Amati 111, Monza, Italy. Electronic address: attilio.giacosa@policlinicodimonza.it. 9. Epidemiology Unit, Istituto Tumori "Fondazione Pascale IRCCS", Via M. Semmola 1, 80131 Naples, Italy. Electronic address: m.montella@istitutotumori.na.it. 10. Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Via G. La Masa 19, 20156 Milan, Italy. Electronic address: alessandra.tavani@marionegri.it. 11. Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Via G.B. Grassi 74, 20157 Milan, Italy. Electronic address: eva.negri@unimi.it. 12. Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Via A. Vanzetti, 5, 20133 Milan, Italy. Electronic address: carlo.lavecchia@unimi.it.
Abstract
BACKGROUND: The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) released in 2007 eight recommendations for cancer prevention on body fatness, diet and physical activity. Our aim is to evaluate the relation between adherence to these recommendations and colorectal cancer (CRC) risk. METHODS: We pooled data from two Italian case-control studies including overall 2419 patients with CRC and 4723 controls. Adherence to the WCRF/AICR guidelines was summarised through a score incorporating seven of the WCRF/AICR recommendations, with higher scores indicating higher adherence to the guidelines. Odds ratios (ORs) of colorectal cancer were estimated using multiple logistic regression models. RESULTS: Higher adherence to the WCRF/AICR recommendations was associated with a significantly reduced CRC risk (OR 0.67, 95% confidence interval, CI, 0.56-0.80 for a score ≥5 versus <3.5), with a significant trend of decreasing risk for increasing adherence (p < 0.001). Consistent results were found for colon (OR 0.67) and rectal cancer (OR 0.67). Inverse associations were observed with the diet-specific WCRF/AICR score (OR 0.71, 95% CI, 0.61-0.84 for ≥3.5 versus <2.5 points) and with specific recommendations on body fatness (OR 0.82, 95% CI, 0.70-0.97), physical activity (OR 0.86, 95% CI, 0.75-1.00), foods and drinks that promote weight gain (OR 0.70, 95% CI, 0.56-0.89), foods of plant origin (OR 0.56, 95% CI, 0.42-0.76), limiting alcohol (OR 0.87, 95% CI, 0.77-0.99) and salt intake (OR 0.63, 95% CI, 0.48-0.84). CONCLUSION: Our study indicated that adherence to the WCRF/AICR recommendations is inversely related to CRC risk.
BACKGROUND: The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) released in 2007 eight recommendations for cancer prevention on body fatness, diet and physical activity. Our aim is to evaluate the relation between adherence to these recommendations and colorectal cancer (CRC) risk. METHODS: We pooled data from two Italian case-control studies including overall 2419 patients with CRC and 4723 controls. Adherence to the WCRF/AICR guidelines was summarised through a score incorporating seven of the WCRF/AICR recommendations, with higher scores indicating higher adherence to the guidelines. Odds ratios (ORs) of colorectal cancer were estimated using multiple logistic regression models. RESULTS: Higher adherence to the WCRF/AICR recommendations was associated with a significantly reduced CRC risk (OR 0.67, 95% confidence interval, CI, 0.56-0.80 for a score ≥5 versus <3.5), with a significant trend of decreasing risk for increasing adherence (p < 0.001). Consistent results were found for colon (OR 0.67) and rectal cancer (OR 0.67). Inverse associations were observed with the diet-specific WCRF/AICR score (OR 0.71, 95% CI, 0.61-0.84 for ≥3.5 versus <2.5 points) and with specific recommendations on body fatness (OR 0.82, 95% CI, 0.70-0.97), physical activity (OR 0.86, 95% CI, 0.75-1.00), foods and drinks that promote weight gain (OR 0.70, 95% CI, 0.56-0.89), foods of plant origin (OR 0.56, 95% CI, 0.42-0.76), limiting alcohol (OR 0.87, 95% CI, 0.77-0.99) and salt intake (OR 0.63, 95% CI, 0.48-0.84). CONCLUSION: Our study indicated that adherence to the WCRF/AICR recommendations is inversely related to CRC risk.
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