. Author manuscript; available in PMC: 2014 Jul 10.

Published in final edited form as: Cancer Prev Res (Phila). 2014 Jan;7(1):42–53. doi: 10.1158/1940-6207.CAPR-13-0258

Table 3.

Associations between ACS guidelines score and cancer incidence (n = 65,838)

Cancer outcome	ACS score	Person-years, (millions)	Events n (%)	Age-adjusted HR (95% CI)	Fully adjusted^a HR (95% CI)
Any cancer (other than non-melanoma skin cancer)
	0—2	1,341	1,475 (13.7)	1.00	1.00
	3	2,011	1,768 (13.5)	0.95 (0.89–1.02)	0.97 (0.91–1.04)
	4	2,711	1,985 (13.2)	0.90 (0.84–0.96)	0.93 (0.86–0.99)
	5	2,261	1,777 (13.0)	0.87 (0.81–0.93)	0.90 (0.84–0.97)
	6	1,008	1,120 (12.4)	0.82 (0.75–0.88)	0.85 (0.78–0.92)
	7—8	216	507 (12.1)	0.79 (0.72–0.88)	0.83 (0.75–0.92)
	P_trend^b			<0.001	<0.001
	Trend^b			0.96 (0.94–0.97)	0.96 (0.95–0.98)
Breast
	0—2	13,76	619 (5.75)	1.00	1.00
	3	2,065	724 (5.51)	0.95 (0.85–1.05)	0.94 (0.84–1.04)
	4	2,779	813 (5.39)	0.90 (0.81–1.00)	0.88 (0.79–0.98)
	5	2,318	732 (5.36)	0.88 (0.79–0.98)	0.85 (0.76–0.95)
	6	1,034	449 (4.97)	0.80 (0.71–0.91)	0.76 (0.67–0.86)
	7—8	221	212 (5.07)	0.82 (0.70–0.96)	0.78 (0.67–0.92)
	P_trend^b			<0.001	<0.001
	Trend^b			0.96 (0.94–0.98)	0.95 (0.93–0.97)
Colorectal
	0—2	1410	145 (1.35)	1.00	1.00
	3	2114	185 (1.41)	0.99 (0.80–1.23)	1.03 (0.83–1.28)
	4	2845	169 (1.12)	0.76 (0.61–0.95)	0.81 (0.65–1.02)
	5	2376	145 (1.06)	0.70 (0.56–0.87)	0.77 (0.61–0.98)
	6	1057	79 (0.87)	0.57 (0.44–0.76)	0.64 (0.49–0.85)
	7—8	226	28 (0.67)	0.43 (0.29–0.65)	0.48 (0.32–0.73)
	P_trend^b			<0.001	<0.001
	Trend^b			0.87 (0.83–0.91)	0.89 (0.85–0.94)
Endometrial
	0—2	1,411	97 (0.90)	1.00	1.00
	3	2,118	103 (0.78)	0.86 (0.65–1.13)	0.85 (0.65–1.13)
	4	2,846	112 (0.74)	0.79 (0.60–1.04)	0.77 (0.58–1.01)
	5	2,378	96 (0.70)	0.74 (0.56–0.95)	0.69 (0.52–0.92)
	6	1,057	68 (0.75)	0.78 (0.57–1.11)	0.71 (0.51–0.97)
	7—8	226	33 (0.79)	0.82 (0.55–1.21)	0.73 (0.49–1.09)
	P_trend^b			0.048	0.008
	Trend^b			0.95 (0.89–1.00)	0.93 (0.87–0.98)
Ovarian
	0—2	1,416	51 (0.47)	1.00	1.00
	3	2,124	58 (0.44)	0.92 (0.63–1.34)	0.93 (0.64–1.36)
	4	2,853	82 (0.54)	1.10 (0.78–1.56)	1.13 (0.79–1.61)
	5	2,384	60 (0.44)	0.87 (0.60–1.27)	0.90 (0.61–1.31)
	6	1,059	52 (0.58)	1.12 (0.76–1.65)	1.16 (0.78–1.72)
	7—8	227	23 (0.55)	1.07 (0.66–1.75)	1.13 (0.68–1.87)
	P_trend^b			0.634	0.494
	Trend^b			1.02 (0.95–1.09)	1.03 (0.95–1.10)
Lung
	0—2	1,413	143 (1.33)	1.00	1.00
	3	2,120	185 (1.41)	1.01 (0.81–1.25)	1.15 (0.93–1.44)
	4	2,848	173 (1.15)	0.79 (0.63–0.98)	1.00 (0.80–1.25)
	5	2,380	181 (1.32)	0.88 (0.71–1.10)	1.22 (0.97–1.52)
	6	1,058	107	0.78 (0.60–1.00)	1.17 (0.91–1.52)
	7—8	227	44	0.68 (0.49–0.96)	1.14 (0.81–1.60)
	P_trend^b			0.004	0.163
	Trend^b			0.94 (0.90–0.98)	1.03 (0.99–1.08)
Other^c
	0—2	1,398	445 (4.14)	1.00	1.00
	3	2,096	526 (4.01)	0.93 (0.82–1.06)	0.95 (0.84–1.08)
	4	2.815	652 (4.33)	0.97 (0.86–1.10)	1.00 (0.88–1.13)
	5	2.352	580 (4.24)	0.93 (0.82–1.05)	0.96 (0.84–1.09)
	6	1,046	387 (4.29)	0.93 (0.81–1.06)	0.96 (0.83–1.10)
	7—8	224	172 (4.11)	0.88 (0.74–1.05)	0.92 (0.77–1.10)
	P_trend^b			0.128	0.383
	Trend^b			0.98 (0.96–1.01)	0.99 (0.96–1.01)

Adjusted for age (continuous), education (≤high school, some college,≥college), smoking pack-years (never smoking, <5, 5–19, 20+), NSAID use at baseline (yes, no), aspirin use at baseline (yes, no), unopposed estrogen use (never, former, current), estrogen + progestin use (never, former, current), multivitamin use at baseline (yes, no), race/ethnicity (NHW, Hispanic, black, Asian, Native American, other), total energy intake (continuous), parous (yes, no, unknown), mammogram (ever, never; included only in models for any cancer and breast cancer), colonoscopy/sigmoidoscopy (ever, never; included only in models for any cancer and colorectal cancer), family history (mother/father, full-blooded sister/brother, daughter/son, grandmother) of cancer (yes, no, unknown), and having a current healthcare provider (yes, no).

Trend tested by modeling ACS score as an ordinal variable (0–8).

Any cancer other than breast, colorectal, endometrial, ovarian, lung, and non-melanoma skin cancer.