Table 5.

Sex-specific hazard ratios and 95% confidence intervals for colorectal cancer associated with subsets of WCRF/AICR cancer prevention recommendations met at baseline after sequentially eliminating the recommendation least associated with a reduction in colorectal cancer risk

WOMEN Recs included:	All recommendations			Alcohol, energy density, plant foods, meat, body fatness (Removed PA)				Energy density, plant foods, meat, body fatness (Removed alcohol)				Plant foods, meat, body fatness (Removed energy density)				Meat, body fatness (Removed plant foods)
Recs met	N Cases	HR (95% CI)‡		Recs met	N Cases	HR (95% CI)‡		Recs met	N Cases	HR (95% CI)‡		Recs met	N Cases	HR (95% CI)‡		Recs met	N Cases	HR (95% CI)‡
None	12	1.00		None	12	1.00		None	82	1.00		None	89	1.00		None	104	1.00
1	77	0.74 (0.40, 1.37)		1	85	0.83 (0.45–1.52)		1	103	0.93 (0.69–1.25)		1	112	0.94 (0.71–1.26)		1	110	0.88 (0.66–1.16)
2	84	0.63 (0.34, 1.17)		2	94	0.75 (0.41–1.37)		2	51	0.68 (0.47–0.98)		2–3	49	0.63 (0.44–0.91)		2	36	0.56 (0.37–0.83)
3	55	0.61 (0.32, 1.14)		3	46	0.58 (0.31–1.12)		3–4	14	0.55 (0.31–0.99)
4–6	22	0.45 (0.22, 0.92)		4–5	13	0.50 (0.23–1.11)
Per rec.		0.86 (0.76, 0.97)				0.84 (0.74–0.96)				0.82 (0.71–0.95)				0.81 (0.68–0.95)				0.77 (0.64–0.93)
Ptrend‡		0.012				0.011				0.007				0.011				0.006
MEN Recs included:	All recommendations			Energy density, body fatness, PA, meat, alcohol (Removed plant foods)				Body fatness, PA, meat, alcohol (Removed energy density)				PA, meat, alcohol (Removed body fatness)				Meat, alcohol (Removed physical activity)
Recs met	N Cases	HR (95% CI)‡		Recs met	N Cases	HR (95% CI)‡		Recs met	N Cases	HR (95% CI)‡		Recs met	N Cases	HR (95% CI)‡		Recs met	N Cases	HR (95% CI)‡
None	35	1.00		None	36	1.00		None	41	1.00		None	57	1.00		None	63	1.00
1	130	0.61 (0.42, 0.89)		1	141	0.64 (0.44–0.93)		1	140	0.56 (0.39–0.79)		1	161	0.50 (0.37–0.68)		1	189	0.55 (0.41–0.74)
2	76	0.50 (0.33, 0.75)		2	70	0.45 (0.30–0.68)		2	77	0.45 (0.30–0.66)		2–3	78	0.44 (0.31–0.64)		2	44	0.44 (0.29–0.67)
3	44	0.68 (0.43, 1.07)		3	42	0.65 (0.41–1.04)		3–4	38	0.50 (0.31–0.79)
4–6	11	0.41 (0.21, 0.82)		4–5	7	0.41 (0.15–0.77)
Per rec.		0.88 (0.78, 1.00)				0.83 (0.73–0.95)				0.81 (0.70–0.93)				0.71 (0.59–0.85)				0.65 (0.52–0.80)
Ptrend‡		0.047				0.008				0.003				<0.001				<0.001

Adjusted for age (as the timeline in the Cox model), education, race/ethnicity, receipt of colonoscopy or sigmoidoscopy in 10 years before baseline, family history of colon or rectal cancer, NSAID use, history of cancer other than colorectal cancer, and total energy intake (kcal/day). Models are further controlled for the eliminated recommendations.

^‡HRs, 95% CIs and P values were calculated using a two-sided test for linear trend modeling categories as a continuous variable.

Abbreviations: CI – confidence interval; HR – hazard ratio; PA – physical activity