Background: Patients with cancer are recommended to follow cancer prevention guidelines due to inadequate evidence for specific recommendations for cancer survivors. Methods: We examined whether diet and lifestyle scores measuring adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention guidelines were associated with colorectal cancer–specific and overall mortality among 1,491 patients with colorectal cancer in two prospective cohorts. Cox proportional hazards regression models were used to calculate the multivariable-adjusted HRs and 95% confidence intervals (CI). Results: During a median follow-up of 7.92 years, there were 641 deaths (179 colorectal cancer–specific deaths). Patients in the highest quartile of the post-diagnostic WCRF/AICR lifestyle score including diet, body mass index (BMI), and physical activity had a 24% lower risk (HR = 0.76, 95% CI: 0.49–1.18) of colorectal cancer–specific mortality and a 37% lower risk (HR = 0.63, 95% CI: 0.50–0.78) of overall mortality compared with the lowest quartile. When BMI was not included in the lifestyle score due to potential disease-related weight loss, stronger inverse associations were observed for both colorectal cancer–specific and overall mortality for the same comparison (colorectal cancer–specific: HR = 0.50, 95% CI: 0.32–0.79; overall: HR = 0.59, 95% CI: 0.47–0.75). The post-diagnostic WCRF/AICR diet score was not statistically significantly associated with either colorectal cancer–specific or overall mortality. Conclusions: Greater adherence to the WCRF/AICR cancer prevention recommendations was associated with improved survival in patients with colorectal cancer. Impact: This study provides support for patients with colorectal cancer to follow cancer prevention recommendations after diagnosis. Future studies on cancer survivors will continue to contribute to evidence-based diet and lifestyle recommendations for patients with cancer.

中文翻译：

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遵守世界癌症研究基金会/美国癌症研究所癌症预防建议和结直肠癌生存

背景：由于对癌症幸存者的具体建议证据不足，建议癌症患者遵循癌症预防指南。方法：我们检查了衡量遵守 2018 年世界癌症研究基金会/美国癌症研究所 (WCRF/AICR) 癌症预防指南的饮食和生活方式评分是否与 1,491 名结直肠癌患者的结直肠癌特异性死亡率和总死亡率相关前瞻性队列。Cox 比例风险回归模型用于计算多变量调整后的 HR 和 95% 置信区间 (CI)。结果：在 7.92 年的中位随访期间，有 641 人死亡（179 例结直肠癌特异性死亡）。诊断后 WCRF/AICR 生活方式评分最高四分位数的患者，包括饮食、体重指数 (BMI) 和体育活动使结直肠癌特异性死亡率降低 24% (HR = 0.76, 95% CI: 0.49–1.18)，降低 37% (HR = 0.63, 95% CI: 0.50-0.78) 的总死亡率与最低四分位数相比。当由于潜在的与疾病相关的体重减轻而导致 BMI 不包括在生活方式评分中时，在相同的比较中观察到结肠直肠癌特异性死亡率和总死亡率的更强负相关（结肠直肠癌特异性：HR = 0.50, 95% CI： 0.32–0.79；总体：HR = 0.59，95% CI：0.47–0.75）。诊断后的 WCRF/AICR 饮食评分与结直肠癌特异性死亡率或总死亡率无统计学显着相关性。结论：更好地遵守 WCRF/AICR 癌症预防建议与提高结直肠癌患者的生存率有关。影响: 本研究为结直肠癌患者在诊断后遵循癌症预防建议提供支持。未来对癌症幸存者的研究将继续为癌症患者提供基于证据的饮食和生活方式建议。