BACKGROUND Adherence to the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) cancer prevention recommendations is associated with colorectal cancer (CRC) risk in whites, but only 1 previous study has reported on this link in African Americans. This study assessed the association between the 2018 WCRF/AICR guidelines and CRC incidence in African Americans (26.5%) and whites (73.5%) in the Atherosclerosis Risk in Communities prospective cohort (n = 13,822). METHODS A total of 368 incident CRC cases (268 among whites and 100 among African Americans) were identified between the baseline (1987) and 2012. A baseline adherence score was created for 7 WCRF/AICR guidelines (each contributing 0, 0.5, or 1 point to the score, with higher scores corresponding to greater adherence). Adherence scores were also categorized as tertiles (0.0-3.0, 3.5-4.0, and 4.5-7.0). Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the total cohort and with stratification by race. RESULTS After adjustments for age, sex, race, center, smoking, education, intake of aspirin, calcium, total calories, diabetes status, and, in women, hormone replacement therapy, greater adherence was associated with decreased CRC risk. The HRs per 1-unit increment in score were 0.88 (95% CI, 0.80-0.97) for the whole cohort, 0.89 (95% CI, 0.73-1.09) for African Americans, and 0.88 (95% CI, 0.77-0.99) for whites. Similar associations between higher adherence scores and decreased cancer risk were observed for men and women and for colon cancer but not for rectal cancer. CONCLUSIONS Greater adherence to the cancer prevention recommendations appears to be associated with decreased CRC risk for both African Americans and whites.

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指南和非裔美国人和白人结直肠癌发病率：社区动脉粥样硬化风险研究。


背景 遵守世界癌症研究基金会 (WCRF)/美国癌症研究所 (AICR) 癌症预防建议与白人结直肠癌 (CRC) 风险相关，但之前只有一项研究报告了非裔美国人的这种关联。本研究评估了社区动脉粥样硬化风险前瞻性队列 (n = 13,822) 中 2018 年 WCRF/AICR 指南与非裔美国人 (26.5%) 和白人 (73.5%) CRC 发病率之间的关联。方法 在基线（1987 年）至 2012 年期间，共发现了 368 例 CRC 病例（其中 268 例为白人，100 例为非裔美国人）。为 7 个 WCRF/AICR 指南创建了基线依从性评分（每个指南贡献 0、0.5 或 1）。指向分数，分数越高，遵守程度越高）。依从性分数也分为三分位数（0.0-3.0、3.5-4.0 和 4.5-7.0）。 Cox 比例风险回归用于计算总队列的风险比 (HR) 和 95% 置信区间 (CI)，并按种族进行分层。结果在调整年龄、性别、种族、中心、吸烟、教育、阿司匹林摄入量、钙、总热量、糖尿病状况以及女性激素替代疗法后，更大的依从性与降低结直肠癌风险相关。整个队列中评分每增加 1 个单位的 HR 为 0.88（95% CI，0.80-0.97），非洲裔美国人为 0.89（95% CI，0.73-1.09），0.88（95% CI，0.77-0.99）对于白人来说。在男性和女性以及结肠癌中观察到更高的依从性分数与降低癌症风险之间存在类似的关联，但在直肠癌中则不然。结论 对于非裔美国人和白人来说，更好地遵守癌症预防建议似乎与降低 CRC 风险有关。