"Postmenopausal women who have greater adherence to cancer prevention guidelines demonstrate a 17 percent lower risk for cancer incidence, 20 percent lower risk for cancer-related death, and 27 percent lower risk for death from all causes," said Cynthia Thomson, Ph.D., R.D., professor of public health at the University of Arizona's Mel and Enid Zuckerman College of Public Health. "We found that the association was stronger for Asian, African-American, and Hispanic women, compared with non-Hispanic white women. It is possible that different ethnic groups may have differential disease course with varied response to environmental and/or behavioral exposures."
"The message is simple and clear: If you want to reduce your risk for cancer, even later in life, eat a healthy diet, be active daily, avoid or limit alcohol, and don't smoke," she said. "Our results support the ACS guidelines for cancer prevention. Certainly, efforts to identify complementary factors that can reduce risk further should be supported as well, because diet and activity alone do not account for the majority of risk," Thomson added.
The ACS guidelines for cancer prevention include four behavior-associated measures: body weight, physical activity, diet, and alcohol consumption. Each component is assigned a numerical score in an effort to quantify diet and physical activity into a single indicator of cancer-preventive behavior. The guidelines are reviewed, updated, and published about every five years, explained Thomson.
Thomson and colleagues analyzed data available from 65,838 postmenopausal women age 50-79, enrolled in the Women's Health Initiative (WHI) Observational Study between 1993 and 1998 at 40 clinical centers across the United States. This is the largest study of postmenopausal women in the United States, according to her.
Behaviors least consistent with the recommendations got a score of zero, and behaviors that met the criteria got scores of one or two depending on the level of adherence to the guidelines, and the scores were added to get the final score for an individual.
The researchers found that a majority of the women had final scores between three and six, with less than 1 percent resorting to behaviors that gave them a score of eight (the maximum score).
Participants were followed for an average of 8.3 years, and during this period, 8,632 cancers were diagnosed and 2,356 deaths due to cancer were recorded.
Compared with those who had the lowest scores (zero to two), those who had the highest scores (seven or eight) had 22 percent lower risk for breast cancer and 52 percent lower risk for colorectal cancer, in addition to having lower risk for all cancers combined, and for death related and unrelated to cancer.
The WHI program is funded by the National Heart, Lung, and Blood Institute; the National Institutes of Health; and the U.S. Department of Health and Human Services. Thomson declared no conflicts of interest.
Thomson is director of the Canyon Ranch Center for Prevention and Health Promotion at the UA Zuckerman College of Public Health and a researcher at the University of Arizona Cancer Center.
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