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Lifestyle-based Cancer Prevention Recommendations

Lifestyle choices that could lower the risk of all cancers

Published on: 30 November 2023

Greater adherence to cancer prevention recommendations — which encourage a healthy lifestyle — lowers the risk of all cancers combined and some individual cancers.

A study by Newcastle University experts, published in BMC Medicine, investigated the relationship between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research recommendations and cancer risk by analysing UK Biobank data for 94,778 British adults, who were the average age of 56.

The cancer prevention recommendations aim to reduce the risk of cancer by encouraging individuals to maintain a healthy weight, be physically active, and eat a diet rich in wholegrains, vegetables, fruit, and beans, but low in highly processed foods, red and processed meat, sugar-sweetened drinks, and alcohol.

Scoring adherence

The researchers used self-reported dietary and physical activity data — in addition to participants’ body mass index and waist circumference measurements — to score participants’ adherence to the recommendations out of a maximum score of seven points.

They used cancer registry data to calculate the incidence of new cancers that developed over an average period of eight years. They accounted for age, sex, socioeconomic deprivation, ethnicity, and smoking status in their analyses.

The average recommendation adherence score was 3.8 points and 7,296 participants (8%) developed cancer during the study period.

The authors found that greater adherence to the WCRF/AICR recommendations was associated with a lower risk of all cancers combined, with each one-point increase in recommendation adherence score associated with a 7% lower risk.

Dr Fiona Malcolmson, Lecturer in Human Nutrition at Newcastle University’s Human Nutrition and Exercise Research Centre, said: “In the UK, there are more than 375,000 new cancer cases every year, and it is estimated that four in 10 cases may be preventable, for example, by adopting a healthier lifestyle.

“Our study suggests that following the WCRF/AICR lifestyle-based Cancer Prevention Recommendations is associated with lowering our risk of cancer, in particular two of the top four cancers in the UK, breast and bowel cancer.”

Lower cancer risk

Compared to those with an adherence scores of 3.5 points or less, those with a score of 4.5 points or above had a 16% lower risk of all cancers combined.

They also found that each 1-point increase in adherence score was associated with a 10% lower risk of breast cancer, a 10% lower risk of colorectal cancer, an 18% lower risk of kidney cancer, a 16% lower risk of oesophageal cancer, a 22% lower risk of liver cancer, a 24% lower risk of ovarian cancer, and a 30% lower risk of gallbladder cancer.

The findings support compliance with the WCRF/AICR recommendations for cancer prevention in the UK, however, the authors note that the observational nature of their study does not allow for conclusions about a causal relationship between WCRF/AICR recommendation adherence and cancer risk.

The authors add that further research is needed to investigate which recommendations may be driving the observed association between recommendation adherence and cancer.


Adherence to the 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations and risk of 14 lifestyle-related cancers in the UK Biobank prospective cohort study. Fiona Malcolmson et al. BMC Medicine.


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