Adherence to cancer prevention guidelines and cancer incidence, cancer mortality, and total mortality: a prospective cohort study

摘要: Background: Several health agencies have issued guidelines promoting behaviors to reduce chronic disease risk; however, little is known about the impact of such guidelines, particularly on cancer incidence. Objective: The objective was determine whether greater adherence American Cancer Society (ACS) prevention associated with a reduction in incidence, mortality, and total mortality. Design: NIH-AARP Diet Health Study, prospective cohort study 566,401 adults aged 50–71 y at recruitment 1995–1996, followed for median 10.5 12.6 13.6 mortality. Participants who reported history or had missing data were excluded, yielding 476,396 subjects analysis. We constructed 5-level score measuring ACS which included baseline body mass index, physical activity, alcohol intake, several aspects diet. Cox proportional hazards models used compute HRs 95% CIs association All analyses fine adjustment cigarette smoking. Results: Among participants, 73,784 incident first cancers, 16,193 deaths, 81,433 deaths from all causes identified cohort. Adherence reduced risk cancers combined: (95% CIs) highest compared lowest level 0.90 (0.87, 0.93) men 0.81 (0.77, 0.84) women. Fourteen 25 specific sites showed increased adherence. also mortality [HRs 0.75 (0.70, 0.80) 0.76 0.83) women] all-cause 0.74 (0.72, 0.76) 0.67 (0.65, 0.70) women]. Conclusions: In both women, reductions all-cancer incidence sites, as well These suggest that, after accounting smoking, set healthy may considerable benefits. This trial registered www.clinicaltrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00340015","term_id":"NCT00340015"}}NCT00340015.