Table 4.
WCRF/AICR Guideline Adherence Scores and Colon Cancer Risk
| Baseline Score1 | Time-Varying Score2 | |||||
|---|---|---|---|---|---|---|
| Colon CA Cases N (%) | Person-Years | HR (95% CI) | P3 | HR (95% CI) | P3 | |
| WCRF/AICR Score | 259 (100) | 654,401 | 1.02 (0.88-1.19) | 0.77 | 1.00 (0.83-1.19) | 0.97 |
| WCRF/AICR Score | 0.84 | 0.72 | ||||
| < 3.0 points | 133 (51.4) | 346,957 | Reference | Reference | ||
| 3.0 – 4.0 points | 117 (45.2) | 270,0366 | 1.13 (0.86-1.49) | 1.08 (0.79-1.48) | ||
| > 4.5 points | 9 (3.5) | 37,078 | 0.72 (0.39-1.34) | 0.54 (0.23-1.26) | ||
| Diet Score | 271 (100) | 677,183 | 1.04 (0.85-1.27) | 0.73 | 1.06 (0.84-1.35) | 0.62 |
| Diet Score4 | 0.29 | 0.49 | ||||
| < 2.0 points | 53 (19.6) | 188,841 | Reference | Reference | ||
| 2.0 – 3.0 points | 201 (74.2) | 444,716 | 1.31 (0.95-1.81) | 1.36 (0.91-2.03) | ||
| > 3.5 points | 17 (6.3) | 43,626 | 0.96 (0.51-1.80) | 1.00 (0.50-1.99) | ||
| Body Composition5 | 0.90 | 0.54 | ||||
| Non-Adherence 2 | 217 (79.2) | 480,383 | Reference | Reference | ||
| Non-Adherence 1 | 40 (14.6) | 133,525 | 0.88 (0.64-1.22) | 0.77 (0.50-1.17) | ||
| Adherence | 17 (6.2) | 65,699 | 1.16 (0.75-1.80) | 1.04 (0.58-1.85) | ||
| Physical Activity4,5 | 0.96 | 0.68 | ||||
| Non-Adherence 2 | 122 (45.7) | 304,990 | Reference | Reference | ||
| Non-Adherence 1 | 116 (43.4) | 286,695 | 0.91 (0.55-1.52) | 1.00 (0.73-1.36) | ||
| Adherence | 29 (10.9) | 83,634 | 0.58 (0.22-1.57) | 1.21 (0.76-1.93) | ||
| Sugar Beverages4,5 | 0.40 | 0.59 | ||||
| Non-Adherence 2 | 142 (51.3) | 387,660 | Reference | Reference | ||
| Non-Adherence 1 | 122 (44.0) | 283,347 | 0.83 (0.64-1.08) | 0.84 (0.62-1.14) | ||
| Adherence | 13 (4.7) | 13,762 | 1.20 (0.62-2.31) | 1.16 (0.61-2.21) | ||
| Plant Foods4,5 | 0.38 | 0.90 | ||||
| Non-Adherence 2 | 194 (71.6) | 518,099 | Reference | Reference | ||
| Non-Adherence 1 | 71 (26.2) | 144,093 | 1.20 (0.90-1.62) | 0.98 (0.69-1.38) | ||
| Adherence | 6 (2.2) | 15,754 | 1.12 (0.51-2.48) | 1.06 (0.45-2.49) | ||
| Red/Processed Meat4,5 | 0.70 | 0.58 | ||||
| Non-Adherence 2 | 53 (19.1) | 158,898 | Reference | Reference | ||
| Non-Adherence 1 | 176 (63.5) | 405,930 | 1.19 (0.88-1.63) | 1.28 (0.87-1.90) | ||
| Adherence | 48 (17.3) | 124,940 | 0.89 (0.58-1.36) | 1.15 (0.70-1.89) | ||
| Alcohol4 | 0.47 | 0.09 | ||||
| Non-Adherence 2 | 2 (0.7) | 9,103 | Reference | Reference | ||
| Non-Adherence 1 | 4 (1.4) | 21,916 | 0.33 (0.11-1.02) | 0.35 (0.05-2.53) | ||
| Adherence | 271 (97.8) | 658,057 | 0.84 (0.41-1.72) | 1.44 (0.35-5.83) | ||
| Salt4,5 | 0.52 | 0.90 | ||||
| Non-Adherence 2 | 111 (40.1) | 302,168 | Reference | Reference | ||
| Non-Adherence 1 | 102 (36.8) | 246,362 | 0.93 (0.65-1.34) | 0.96 (0.63-1.47) | ||
| Adherence | 64 (23.1) | 141,100 | 1.14 (0.71-1.82) | 0.96 (0.55-1.69) | ||
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)
6Additionlly adjusted for physical activity (high, moderate, low) and sedentary time (≥ 8, 5-7, ≤ 5 hrs./day sitting)