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A systematic review and meta-analysis of the 2007 WCRF/AICR score in relation to cancer-related health outcomes.
Annals of Oncology ( IF 50.5 ) Pub Date : 2020-01-08 , DOI: 10.1016/j.annonc.2020.01.001
M Solans 1 , D S M Chan 2 , P Mitrou 3 , T Norat 2 , D Romaguera 4
Affiliation  

BACKGROUND We conducted a systematic literature review and meta-analysis of observational studies investigating adherence to the 2007 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations for cancer prevention and health outcomes. PATIENTS AND METHODS We searched PubMed and the in-house database of the WCRF Continuous Update Project for publications up to June 2019. Cross-sectional studies were only narratively reviewed given their heterogeneity while findings of cohort/case-control studies were synthesized in umbrella reviews and meta-analyses. Summary relative risks (RRs) and 95% confidence intervals (CI) were estimated using a random-effects model when at least two studies reported results on a specific outcome. RESULTS Thirty-eight articles (17 prospective, 8 case-control, and 13 cross-sectional studies) were included. The summary RR per each point increment in the 2007 WCRF/AICR score was 0.90 (95% CI: 0.87-0.93, n = 11) for breast cancer, regardless of hormone receptor and menopausal status, 0.86 (95% CI: 0.82-0.89, n = 10) for colorectal cancer, and 0.93 (95% CI: 0.89-0.96, n = 2) for lung cancer risk. No statistically significant associations were reported for prostate (n = 6) and pancreatic cancers (n = 2). Adherence to the recommendations was associated with lower overall mortality (RR = 0.90, 95% CI 0.84-0.96, n = 3) and cancer-specific mortality (RR = 0.91, 95% CI 0.89-0.92; n = 3) in healthy populations, as well as with higher survival in cancer patients (n = 2). In cross-sectional studies, a healthier plasma marker profile and lower cancer risk factors in the general population and a better health status and quality of life in cancer patients/survivors were reported. CONCLUSIONS Adhering to the 2007 WCRF/AICR recommendations is associated with lower risks of cancer incidence, namely breast and colorectal cancers, and mortality. Primary prevention of cancer should emphasize modification of multiple lifestyle factors. Upcoming studies examining the recently updated 2018 guidelines will further clarify such associations.

中文翻译:

对 2007 年 WCRF/AICR 评分与癌症相关健康结果相关的系统评价和荟萃分析。

背景 我们对观察性研究进行了系统的文献回顾和荟萃分析,调查了 2007 年世界癌症研究基金会/美国癌症研究所 (WCRF/AICR) 对癌症预防和健康结果的生活方式建议的遵守情况。患者和方法 我们在 PubMed 和 WCRF 持续更新项目的内部数据库中搜索了截至 2019 年 6 月的出版物。鉴于其异质性,横断面研究仅进行了叙述性审查,而队列/病例对照研究的结果在综合审查中进行了综合和荟萃分析。当至少有两项研究报告了特定结果的结果时,使用随机效应模型估计了汇总相对风险 (RR) 和 95% 置信区间 (CI)。结果 38 篇文章(17 篇前瞻性,8 篇病例对照,和 13 项横断面研究)被包括在内。无论激素受体和绝经状态如何,2007 年 WCRF/AICR 评分中每增加一个点的总 RR 为 0.90(95% CI:0.87-0.93,n = 11),乳腺癌为 0.86(95% CI:0.82-0.89) , n = 10) 用于结直肠癌,0.93 (95% CI: 0.89-0.96, n = 2) 用于肺癌风险。前列腺癌(n = 6)和胰腺癌(n = 2)未报告有统计学意义的关联。在健康人群中,遵守建议与较低的总体死亡率(RR = 0.90, 95% CI 0.84-0.96, n = 3)和癌症特异性死亡率(RR = 0.91, 95% CI 0.89-0.92; n = 3)相关,以及癌症患者的存活率更高(n = 2)。在横断面研究中,据报道,普通人群的血浆标志物谱更健康,癌症风险因素更低,癌症患者/幸存者的健康状况和生活质量更好。结论 坚持 2007 年 WCRF/AICR 的建议与降低癌症发病率(即乳腺癌和结直肠癌)和死亡率相关。癌症的一级预防应强调改变多种生活方式因素。即将进行的研究检查最近更新的 2018 年指南将进一步阐明此类关联。
更新日期:2020-01-08
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