Table 3.
WCRF/AICR Guideline Adherence Scores and Colorectal Cancer Risk
| Baseline Score1 | Time-Varying Score2 | |||||
|---|---|---|---|---|---|---|
| CRC Cases N (%) | Person-Years | HR (95% CI) | P3 | HR (95% CI) | P3 | |
| WCRF/AICR Score | 328 (100) | 653,929 | 1.01 (0.89-1.16) | 0.84 | 0.98 (0.84-1.15) | 0.79 |
| WCRF/AICR Score | 0.74 | 0.67 | ||||
| < 3.0 points | 166 (50.6) | 346,736 | Reference | Reference | ||
| 3.0 – 4.0 points | 152 (46.3) | 270,144 | 1.11 (0.86-1.42) | 1.11 (0.84-1.46) | ||
| > 4.0 points | 10 (3.0) | 37,049 | 0.86 (0.52-1.44) | 0.51 (0.23-1.10) | ||
| Diet Score | 348 (100) | 676,638 | 1.05 (0.88-1.25) | 0.61 | 1.01 (0.82-1.24) | 0.92 |
| Diet Score4 | 0.29 | 0.92 | ||||
| < 2.0 points | 76 (21.8) | 188,690 | Reference | Reference | ||
| 2.0 – 3.0 points | 250 (71.8) | 444,363 | 1.26 (0.95-1.67) | 1.13 (0.81-1.58) | ||
| > 3.5 points | 22 (6.3) | 43,585 | 0.97 (0.56-1.68) | 0.88 (0.48-1.58) | ||
| Body Composition5 | 0.61 | 0.96 | ||||
| Non-Adherence 2 | 274 (79.2) | 480,017 | Reference | Reference | ||
| Non-Adherence 1 | 47 (13.6) | 133,461 | 0.98 (0.74-1.29) | 0.76 (0.52-1.10) | ||
| Adherence | 25 (7.2) | 65,640 | 1.16 (0.79-1.69) | 1.26 (0.80-2.00) | ||
| Physical Activity4,5 | 0.97 | 0.82 | ||||
| Non-Adherence 2 | 154 (45.2) | 304,769 | Reference | Reference | ||
| Non-Adherence 1 | 152 (44.6) | 286,463 | 1.01 (0.64-1.58) | 1.00 (0.76-1.31) | ||
| Adherence | 35 (10.3) | 83,558 | 0.95 (0.40-2.27) | 1.13 (0.74-1.71) | ||
| Sugar Beverages4,5 | 0.57 | 0.88 | ||||
| Non-Adherence 2 | 184 (52.0) | 387,366 | Reference | Reference | ||
| Non-Adherence 1 | 153 (43.2) | 283,115 | 0.86 (0.68-1.09) | 0.83 (0.63-1.08) | ||
| Adherence | 17 (4.8) | 18,742 | 1.29 (0.72-2.30) | 1.24 (0.71-2.17) | ||
| Plant Foods4,5 | 0.26 | 0.98 | ||||
| Non-Adherence 2 | 246 (70.7) | 517,744 | Reference | Reference | ||
| Non-Adherence 1 | 95 (27.3) | 143,918 | 1.30 (1.00-1.68) | 1.04 (0.77-1.41) | ||
| Adherence | 7 (2.0) | 15,740 | 0.87 (0.40-1.91) | 0.93 (0.42-2.04) | ||
| Red/Processed Meat4,5 | 0.60 | 0.93 | ||||
| Non-Adherence 2 | 74 (20.9) | 158,779 | Reference | Reference | ||
| Non-Adherence 1 | 219 (61.9) | 405,608 | 1.13 (0.86-1.48) | 1.12 (0.81-1.56) | ||
| Adherence | 61 (17.2) | 124,836 | 0.88 (0.60-1.27) | 0.98 (0.64-1.50) | ||
| Alcohol4 | 0.46 | 0.26 | ||||
| Non-Adherence 2 | 3 (0.9) | 9,094 | Reference | Reference | ||
| Non-Adherence 1 | 6 (1.7) | 21,898 | 0.59 (0.24-1.47) | 0.71 (0.18-2.96) | ||
| Adherence | 343 (97.4) | 657,540 | 0.97 (0.49-1.90) | 1.25 (0.40-3.92) | ||
| Salt4,5 | 0.41 | 1.00 | ||||
| Non-Adherence 2 | 145 (41.0) | 301,958 | Reference | Reference | ||
| Non-Adherence 1 | 130 (36.7) | 246.144 | 0.96 (0.70-1.32) | 1.01 (0.70-1.46) | ||
| Adherence | 79 (22.3) | 140,983 | 1.17 (0.7701.77) | 1.00 (0.61-1.64) | ||
Cox proportional hazards regression. WCRF Score and covariates are all baseline (1995) data only. Covariates included: age, geographic region of residence (Northeast, South, Midwest, West, other), caloric intake (continuous), smoking (never, former, <15 cigarettes/day, ≥15 cigarettes/day), family history of colorectal cancer (yes/no), education (≤12, 13-15, ≥16 years), menopausal status (pre/post), diabetes (yes/no), insulin usage (yes/no), aspirin usage (yes/no), colonoscopy (yes/no), sigmoidoscopy (yes/no)
Cox proportional hazards regression. Time-varying analysis using Anderson-Gill Method to update both WCRF score and covariates. Covariates included: age, geographic region of residence (Northeast, South, Midwest, West, other), caloric intake (continuous), smoking (never, former, <15 cigarettes/day, ≥15 cigarettes/day), family history of colorectal cancer (yes/no), education (≤12, 13-15, ≥16 years), menopausal status (pre/post), diabetes (yes/no), insulin usage (yes/no), aspirin usage (yes/no), colonoscopy (yes/no), sigmoidoscopy (yes/no)
Test for trend.
Additionally adjusted for: BMI (<25, 25-<30, ≥30 kg/m2)
Additionally adjusted for alcohol (<1, 1-6, 7-13, >13 drinks/week)
6 Additionally adjusted for physical activity high, moderate, low) and sedentary time (≥ 8, 5-7, ≤ 5 hrs./day sitting)