Ashley H Tjaden, Audrey A Goldbaum, Sharon L Edelstein, Brandy M Heckman-Stoddard, Jill Reedy, William H Herman, Mary Hoskin, William C Knowler, Mathias Schlögl, Karla A Temple, Elizabeth M Venditti, Karol Watson, Marinella Temprosa, Marissa M Shams-White
{"title":"2018年世界癌症研究基金会/美国癌症研究所癌症研究评分和癌症风险：来自糖尿病预防项目结果研究的结果。","authors":"Ashley H Tjaden, Audrey A Goldbaum, Sharon L Edelstein, Brandy M Heckman-Stoddard, Jill Reedy, William H Herman, Mary Hoskin, William C Knowler, Mathias Schlögl, Karla A Temple, Elizabeth M Venditti, Karol Watson, Marinella Temprosa, Marissa M Shams-White","doi":"10.1016/j.ajcnut.2025.07.011","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Modifying lifestyle factors may reduce the incidence of obesity, diabetes, and cancer.</p><p><strong>Objective: </strong>We examined how alignment with the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations using the 2018 WCRF/AICR Score was associated with incident lifestyle-related cancer in adults with prediabetes in the Diabetes Prevention Program (DPP, 1996-2001) and DPP Outcomes Study (DPPOS, 2002-2020), an observational follow-up of a randomized clinical trial.</p><p><strong>Methods: </strong>Participants were randomized to lifestyle, metformin, or placebo interventions (mean 3y) and followed for an additional 19y. The 2018 WCRF/AICR Score (0-7 points; higher score, better alignment) was calculated from body weight, physical activity, diet, and alcohol components at 0, 1, 5, 6, 9, and 15y after randomization. Incident cancer was based on the 2018 WCRF/AICR 3rd Expert Report (18 cancers associated with lifestyle). Adjusted Cox proportional hazard models estimated associations between the Score (baseline [0], change from 0-1y, time-dependent) and lifestyle-related cancer.</p><p><strong>Results: </strong>Participants' (N=3000) mean baseline WCRF/AICR Score was 3.2 (SD=1.1). There were 403 incident lifestyle-related cancer cases. Scores improved after 1y and 15y (mean increase=0.43 and 0.27pts, respectively, both p<0.001). The baseline Score was not associated with cancer risk. However, a 1-unit Score improvement from 0-1y and time-dependent Scores were significantly associated with a 14% (Hazard Ratio (HR)=0.86; 95% Confidence Interval (CI) 0.76, 0.97) and 9% (HR=0.91; 95% CI 0.83, 0.997) lower risk, respectively, with no effect modification by intervention group or diabetes status. In exploratory by-component analyses, no single component was associated with risk.</p><p><strong>Conclusions: </strong>Alignment with WCRF/AICR Recommendations may lower cancer risk in adults with prediabetes and type 2 diabetes, highlighting the importance of considering lifestyle factors for cancer prevention.</p><p><strong>Trial registration number: </strong>Diabetes Prevention Program, NCT00004992; Diabetes Prevention Program Outcomes Study, NCT00038727 DPP STUDY REGISTRATION PAGE: https://clinicaltrials.gov/study/NCT00004992 DPPOS STUDY REGISTRATION PAGE: https://clinicaltrials.gov/study/NCT00038727.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5000,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The 2018 World Cancer Research Fund /American Institute for Cancer Research Score and Cancer Risk: Results from the Diabetes Prevention Program Outcomes Study.\",\"authors\":\"Ashley H Tjaden, Audrey A Goldbaum, Sharon L Edelstein, Brandy M Heckman-Stoddard, Jill Reedy, William H Herman, Mary Hoskin, William C Knowler, Mathias Schlögl, Karla A Temple, Elizabeth M Venditti, Karol Watson, Marinella Temprosa, Marissa M Shams-White\",\"doi\":\"10.1016/j.ajcnut.2025.07.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Modifying lifestyle factors may reduce the incidence of obesity, diabetes, and cancer.</p><p><strong>Objective: </strong>We examined how alignment with the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations using the 2018 WCRF/AICR Score was associated with incident lifestyle-related cancer in adults with prediabetes in the Diabetes Prevention Program (DPP, 1996-2001) and DPP Outcomes Study (DPPOS, 2002-2020), an observational follow-up of a randomized clinical trial.</p><p><strong>Methods: </strong>Participants were randomized to lifestyle, metformin, or placebo interventions (mean 3y) and followed for an additional 19y. The 2018 WCRF/AICR Score (0-7 points; higher score, better alignment) was calculated from body weight, physical activity, diet, and alcohol components at 0, 1, 5, 6, 9, and 15y after randomization. Incident cancer was based on the 2018 WCRF/AICR 3rd Expert Report (18 cancers associated with lifestyle). Adjusted Cox proportional hazard models estimated associations between the Score (baseline [0], change from 0-1y, time-dependent) and lifestyle-related cancer.</p><p><strong>Results: </strong>Participants' (N=3000) mean baseline WCRF/AICR Score was 3.2 (SD=1.1). There were 403 incident lifestyle-related cancer cases. Scores improved after 1y and 15y (mean increase=0.43 and 0.27pts, respectively, both p<0.001). The baseline Score was not associated with cancer risk. However, a 1-unit Score improvement from 0-1y and time-dependent Scores were significantly associated with a 14% (Hazard Ratio (HR)=0.86; 95% Confidence Interval (CI) 0.76, 0.97) and 9% (HR=0.91; 95% CI 0.83, 0.997) lower risk, respectively, with no effect modification by intervention group or diabetes status. In exploratory by-component analyses, no single component was associated with risk.</p><p><strong>Conclusions: </strong>Alignment with WCRF/AICR Recommendations may lower cancer risk in adults with prediabetes and type 2 diabetes, highlighting the importance of considering lifestyle factors for cancer prevention.</p><p><strong>Trial registration number: </strong>Diabetes Prevention Program, NCT00004992; Diabetes Prevention Program Outcomes Study, NCT00038727 DPP STUDY REGISTRATION PAGE: https://clinicaltrials.gov/study/NCT00004992 DPPOS STUDY REGISTRATION PAGE: https://clinicaltrials.gov/study/NCT00038727.</p>\",\"PeriodicalId\":50813,\"journal\":{\"name\":\"American Journal of Clinical Nutrition\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.5000,\"publicationDate\":\"2025-07-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Clinical Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ajcnut.2025.07.011\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Clinical Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ajcnut.2025.07.011","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
The 2018 World Cancer Research Fund /American Institute for Cancer Research Score and Cancer Risk: Results from the Diabetes Prevention Program Outcomes Study.
Background: Modifying lifestyle factors may reduce the incidence of obesity, diabetes, and cancer.
Objective: We examined how alignment with the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations using the 2018 WCRF/AICR Score was associated with incident lifestyle-related cancer in adults with prediabetes in the Diabetes Prevention Program (DPP, 1996-2001) and DPP Outcomes Study (DPPOS, 2002-2020), an observational follow-up of a randomized clinical trial.
Methods: Participants were randomized to lifestyle, metformin, or placebo interventions (mean 3y) and followed for an additional 19y. The 2018 WCRF/AICR Score (0-7 points; higher score, better alignment) was calculated from body weight, physical activity, diet, and alcohol components at 0, 1, 5, 6, 9, and 15y after randomization. Incident cancer was based on the 2018 WCRF/AICR 3rd Expert Report (18 cancers associated with lifestyle). Adjusted Cox proportional hazard models estimated associations between the Score (baseline [0], change from 0-1y, time-dependent) and lifestyle-related cancer.
Results: Participants' (N=3000) mean baseline WCRF/AICR Score was 3.2 (SD=1.1). There were 403 incident lifestyle-related cancer cases. Scores improved after 1y and 15y (mean increase=0.43 and 0.27pts, respectively, both p<0.001). The baseline Score was not associated with cancer risk. However, a 1-unit Score improvement from 0-1y and time-dependent Scores were significantly associated with a 14% (Hazard Ratio (HR)=0.86; 95% Confidence Interval (CI) 0.76, 0.97) and 9% (HR=0.91; 95% CI 0.83, 0.997) lower risk, respectively, with no effect modification by intervention group or diabetes status. In exploratory by-component analyses, no single component was associated with risk.
Conclusions: Alignment with WCRF/AICR Recommendations may lower cancer risk in adults with prediabetes and type 2 diabetes, highlighting the importance of considering lifestyle factors for cancer prevention.
Trial registration number: Diabetes Prevention Program, NCT00004992; Diabetes Prevention Program Outcomes Study, NCT00038727 DPP STUDY REGISTRATION PAGE: https://clinicaltrials.gov/study/NCT00004992 DPPOS STUDY REGISTRATION PAGE: https://clinicaltrials.gov/study/NCT00038727.
期刊介绍：
American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism.
Purpose:
The purpose of AJCN is to:
Publish original research studies relevant to human and clinical nutrition.
Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits.
Encourage public health and epidemiologic studies relevant to human nutrition.
Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches.
Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles.
Peer Review Process:
All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.
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