Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations and colorectal cancer risk

Federica Turati, Francesca Bravi, Matteo Di Maso, Cristina Bosetti, Jerry Polesel, Diego Serraino, Michela Dalmartello, Attilio Giacosa, Maurizio Montella, Alessandra Tavani, Eva Negri, Carlo La Vecchia

Research output: Contribution to journalArticlepeer-review


Background The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) released in 2007 eight recommendations for cancer prevention on body fatness, diet and physical activity. Our aim is to evaluate the relation between adherence to these recommendations and colorectal cancer (CRC) risk. Methods We pooled data from two Italian case–control studies including overall 2419 patients with CRC and 4723 controls. Adherence to the WCRF/AICR guidelines was summarised through a score incorporating seven of the WCRF/AICR recommendations, with higher scores indicating higher adherence to the guidelines. Odds ratios (ORs) of colorectal cancer were estimated using multiple logistic regression models. Results Higher adherence to the WCRF/AICR recommendations was associated with a significantly reduced CRC risk (OR 0.67, 95% confidence interval, CI, 0.56–0.80 for a score ≥5 versus <3.5), with a significant trend of decreasing risk for increasing adherence (p < 0.001). Consistent results were found for colon (OR 0.67) and rectal cancer (OR 0.67). Inverse associations were observed with the diet-specific WCRF/AICR score (OR 0.71, 95% CI, 0.61–0.84 for ≥3.5 versus <2.5 points) and with specific recommendations on body fatness (OR 0.82, 95% CI, 0.70–0.97), physical activity (OR 0.86, 95% CI, 0.75–1.00), foods and drinks that promote weight gain (OR 0.70, 95% CI, 0.56–0.89), foods of plant origin (OR 0.56, 95% CI, 0.42–0.76), limiting alcohol (OR 0.87, 95% CI, 0.77–0.99) and salt intake (OR 0.63, 95% CI, 0.48–0.84). Conclusion Our study indicated that adherence to the WCRF/AICR recommendations is inversely related to CRC risk.

Original languageEnglish
Pages (from-to)86-94
Number of pages9
JournalEuropean Journal of Cancer
Publication statusPublished - Nov 1 2017


  • Case–control
  • Colorectal neoplasms
  • Diet
  • Nutrition policy
  • Prevention

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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