Table 3.
WCRF/AICR Guideline Adherence Scores and Breast Cancer Risk
| Baseline Score1 | Time-Varying Score2 | |||||
|---|---|---|---|---|---|---|
|
|
||||||
| Cases N (%) |
Person-Years | HR (95% CI) | P3 | HR (95% CI) | P3 | |
| WCRF/AICR Score4 | 1,567 | 646,097 | 0.96 (0.90–1.02) | 0.16 | 0.89 (0.84–0.96) | 0.002 |
| WCRF/AICR Score | 0.66 | 0.02 | ||||
| < 3.0 points | 727 (46.4) | 342,263 | Reference | Reference | ||
| 3.0 – 4.0 points | 720 (46.0) | 266,850 | 1.01 (0.90–1.12) | 0.87 (0.78–0.99) | ||
| > 4.0 points | 120 (7.7) | 36,784 | 0.95 (0.77–1.16) | 0.84 (0.65–1.08) | ||
| Diet Score4,5,6 | 1,766 | 658,647 | 0.99 (0.91–1.07) | 0.71 | 0.91 (0.83–0.99) | 0.04 |
| Diet Score5,6 | 0.52 | 0.58 | ||||
| < 2.0 points | 499 (28.3) | 186,864 | Reference | Reference | ||
| 2.0 – 3.0 points | 1,155 (65.4) | 428,748 | 0.96 (0.86–1.09) | 0.98 (0.85–1.12) | ||
| > 3.0 points | 112 (6.3) | 43,035 | 0.95 (0.76–1.19) | 0.89 (0.70–1.13) | ||
| Body Weight6,7 | 0.65 | 0.79 | ||||
| Non-Adherence | 1,214 (67.8) | 473,613 | Reference | Reference | ||
| Partial Adherence | 382 (21.3) | 132,326 | 0.92 (0.82–1.04) | 0.96 (0.83–1.10) | ||
| Adherence | 196 (10.9) | 65,157 | 1.02 (0.87–1.19) | 1.00 (0.81–1.25) | ||
| Physical Activity5,6 | 0.03 | 0.003 | ||||
| Non-Adherence | 554 (33.7) | 300,817 | Reference | Reference | ||
| Partial Adherence | 742 (45.1) | 282,958 | 0.98 (0.87–1.09) | 0.92 (0.82–1.03) | ||
| Adherence | 349 (21.2) | 83,020 | 0.85 (0.74–0.97) | 0.73 (0.60–0.89) | ||
| Sugar Beverages5,6,7 | 0.70 | 0.02 | ||||
| Non-Adherence | 1,033 (56.5) | 383,265 | Reference | Reference | ||
| Partial Adherence | 763 (41.8) | 279,346 | 1.03 (0.93–1.14) | 0.91 (0.81–1.02) | ||
| Adherence | 31 (1.7) | 18,515 | 0.71 (0.50–1.02) | 0.73 (0.54–1.00) | ||
| Plant Foods5,6,7 | 0.87 | 0.49 | ||||
| Non-Adherence | 1,342 (75.7) | 512,124 | Reference | Reference | ||
| Partial Adherence | 400 (22.6) | 141,844 | 1.06 (0.94–1.20) | 1.04 (0.91–1.18) | ||
| Adherence | 32 (1.8) | 15,442 | 0.81 (0.56–1.16) | 1.10 (0.81–1.50) | ||
| Red/Processed Meat5,6,7 | 0.49 | 0.01 | ||||
| Non-Adherence | 453 (24.8) | 156,934 | Reference | Reference | ||
| Partial Adherence | 1,050 (57.5) | 400,760 | 0.94 (0.84–1.06) | 0.88 (0.77–1.01) | ||
| Adherence | 324 (17.7) | 123,431 | 0.95 (0.82–1.11) | 0.80 (0.66–0.95) | ||
| Alcohol5,7 | 0.21 | 0.49 | ||||
| Non-Adherence | 40 (2.2) | 9,004 | Reference | Reference | ||
| Partial Adherence | 93 (5.1) | 21,628 | 1.18 (0.81–1.71) | 1.40 (0.82–2.39) | ||
| Adherence | 1,687 (92.7) | 649,801 | 0.96 (0.70–1.31) | 1.12 (0.69–1.81) | ||
| Salt5,6,7 | 0.27 | 0.98 | ||||
| Non-Adherence | 731 (40.0) | 298,466 | Reference | Reference | ||
| Partial Adherence | 672 (36.8) | 243,247 | 1.03 (0.89–1.18) | 0.88 (0.75–1.02) | ||
| Adherence | 423 (23.2) | 139,274 | 1.11 (0.92–1.33) | 1.00 (0.82–1.23) | ||
Abbreviations: AICR, American Institute for Cancer Research; CI, confidence interval; HR, hazard ratio; N, number; WCRF, World Cancer Research Fund
WCRF Score and covariates are all baseline (1995) data only. Covariates: age, geographic region of residence (Northeast, South, Midwest, West, other), kilocalories/day (continuous), smoking (never, former, <15 cigarettes/day, ≥15 cigarettes/day), family history of breast cancer (yes/no), education (≤12, 13–15, ≥16 years), menopausal status (pre/post), oral contraceptive use (never, 0.5–5, ≥5 years), parity (none, 1–2, ≥3 children), menopausal hormone use (premenopausal, postmenopausal-never, postmenopausal-<5 years, postmenopausal- ≥ 5 years)
Time-varying analysis using Anderson-Gill Method to update both WCRF score and covariates. Covariates same as baseline model.
Test for trend.
Per 0.5 unit increase.
Additionally adjusted for: BMI (<25, 25-<30, ≥30 kg/m2)
Additionally adjusted for alcohol (<1, 1–6, 7–13, ≥14 drinks/week)
Additionally adjusted for physical activity (high, moderate, low) and sedentary time (≥ 8, 5–7, ≤ 5 hrs./day sitting)