Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the women's health initiative

Cynthia A. Thomson, Marjorie L. McCullough, Betsy C. Wertheim, Rowan T. Chlebowski, Maria Elena Martinez, Marcia L. Stefanick, Thomas E. Rohan, Joann E. Manson, Hilary A. Tindle, Judith Ockene, Mara Z. Vitolins, Jean Wactawski-Wende, Gloria E. Sarto, Dorothy S. Lane, Marian L. Neuhouser

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Abstract

Healthy lifestyle behaviors are recommended to reduce cancer risk and overall mortality. Adherence to cancer-preventive health behaviors and subsequent cancer risk has not been evaluated in a diverse sample of postmenopausal women. We examined the association between the American Cancer Society (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines score and risk of incident cancer, cancer-specific mortality, and all-cause mortality in 65,838 postmenopausal women enrolled in the Women's Health Initiative Observational Study. ACS guidelines scores (0-8 points) were determined from a combined measure of diet, physical activity, body mass index (current and at age 18 years), and alcohol consumption. After a mean follow-up of 12.6 years, 8,632 incident cancers and 2,356 cancer deaths were identified. The highest ACS guidelines scores compared with the lowest were associated with a 17% lower risk of any cancer [HR, 0.83; 95% confidence interval (CI), 0.75-0.92], 22% lower risk of breast cancer (HR, 0.78; 95% CI, 0.67-0.92), 52% lower risk of colorectal cancer (HR, 0.48; 95% CI, 0.32-0.73), 27% lower risk of all-cause mortality, and 20% lower risk of cancer-specific mortality (HR, 0.80; 95% CI, 0.71-0.90). Associations with lower cancer incidence and mortality were generally strongest among Asian, black, and Hispanic women and weakest among non-Hispanic whites. Behaviors concordant with Nutrition and Physical Activity Cancer Prevention Guidelines were associated with lower risk of total, breast, and colorectal cancers and lower cancer-specific mortality in postmenopausal women.

Original languageEnglish (US)
Pages (from-to)42-53
Number of pages12
JournalCancer Prevention Research
Volume7
Issue number1
DOIs
StatePublished - Jan 2014

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Women's Health
Guidelines
Exercise
Mortality
Neoplasms
Confidence Intervals
Colorectal Neoplasms
Breast Neoplasms
Health Behavior
Hispanic Americans
Alcohol Drinking
Observational Studies
Body Mass Index

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Thomson, C. A., McCullough, M. L., Wertheim, B. C., Chlebowski, R. T., Martinez, M. E., Stefanick, M. L., ... Neuhouser, M. L. (2014). Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the women's health initiative. Cancer Prevention Research, 7(1), 42-53. https://doi.org/10.1158/1940-6207.CAPR-13-0258

Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the women's health initiative. / Thomson, Cynthia A.; McCullough, Marjorie L.; Wertheim, Betsy C.; Chlebowski, Rowan T.; Martinez, Maria Elena; Stefanick, Marcia L.; Rohan, Thomas E.; Manson, Joann E.; Tindle, Hilary A.; Ockene, Judith; Vitolins, Mara Z.; Wactawski-Wende, Jean; Sarto, Gloria E.; Lane, Dorothy S.; Neuhouser, Marian L.

In: Cancer Prevention Research, Vol. 7, No. 1, 01.2014, p. 42-53.

Research output: Contribution to journalArticle

Thomson, CA, McCullough, ML, Wertheim, BC, Chlebowski, RT, Martinez, ME, Stefanick, ML, Rohan, TE, Manson, JE, Tindle, HA, Ockene, J, Vitolins, MZ, Wactawski-Wende, J, Sarto, GE, Lane, DS & Neuhouser, ML 2014, 'Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the women's health initiative', Cancer Prevention Research, vol. 7, no. 1, pp. 42-53. https://doi.org/10.1158/1940-6207.CAPR-13-0258
Thomson, Cynthia A. ; McCullough, Marjorie L. ; Wertheim, Betsy C. ; Chlebowski, Rowan T. ; Martinez, Maria Elena ; Stefanick, Marcia L. ; Rohan, Thomas E. ; Manson, Joann E. ; Tindle, Hilary A. ; Ockene, Judith ; Vitolins, Mara Z. ; Wactawski-Wende, Jean ; Sarto, Gloria E. ; Lane, Dorothy S. ; Neuhouser, Marian L. / Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the women's health initiative. In: Cancer Prevention Research. 2014 ; Vol. 7, No. 1. pp. 42-53.
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