Erikka Loftfield

Ph.D., M.P.H.

Erikka Loftfield Cronin

Investigator

PLCO (Learn more about this study)

PLCO-1584

Jun 7, 2024

Adherence to the 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations and risk of lifestyle-related cancers in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial

The World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations are ten lifestyle-based recommendations which aim to reduce the risk of (any) cancer worldwide. These were updated in 2018 to reflect the latest scientific evidence. Subsequently, a standardised scoring system (the ‘2018 WCRF/AICR Score’) was created to standardise how adherence to the recommendations was measured, as well as to promote research investigating associations between this Score and cancer-related outcomes. In the UK Biobank prospective cohort study, which recruited >500,000 participants across the UK, we have previously reported a reduction in the risk of cancer overall, as well as of individual cancer sites including breast and colorectal, with greater adherence to the Recommendations (i.e., higher Scores). Further, in the NIH-AARP Diet & Health Study, higher adherence scores were associated with lower risk of the top three cancer sites in the US (combined) and breast, colorectal, and lung cancer.

An ‘unhealthier’ lifestyle (lower adherence score) could result in increased cancer risk through metabolic changes. For example, individual dietary and lifestyle factors such as BMI and the intake of red meat have been associated with concentrations of biomarkers and metabolites associated with cancer risk. To our knowledge, associations between 2018 WCRF/AICR Score and the concentrations of biomarkers and metabolites that may be associated with cancer risk have not yet been explored.

The main aim of this study is to investigate associations between 2018 WCRF/AICR Score and the risk of i) any cancer (cancer overall) and ii) individual cancer sites including breast, colorectal, liver, and endometrial cancers, in a US population (PLCO Cancer Screening Trial). Importantly, the PLCO Study includes additional cancer information e.g., histology, which is not readily available in other such as the UK Biobank. Thus, this study would also aim to explore whether these factors modulate associations between diet and lifestyle and cancer risk.

Secondly, this study aims to use existing metabolomic data to explore the associations of individual metabolite levels and poly-metabolite signatures (with the 2018 WCRF/AICR Score and to test whether these lifestyle-related markers are associated with the risk of developing cancers. The unique nature of the PLCO study in collecting serial measurements will also allow for the exploration of within-person variability in 2018 WCRF/AICR Score and in levels of biomarkers and metabolites over time using an existing metabolomics dataset that includes 50 men and 50 women with metabolomics measures for three serial samples each.