Adherence to the 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations and risk of mortality in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial
Principal Investigator
Name
Fiona Malcomson
Degrees
Ph.D., M.Res., PG.Dip., B.Sc (Hons)
Institution
Newcastle University
Position Title
Researcher (former Assistant Professor)
About this CDAS Project
Study
PLCO
(Learn more about this study)
Project ID
PLCO-2069
Initial CDAS Request Approval
Jul 27, 2026
Title
Adherence to the 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations and risk of mortality in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial
Summary
The World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations are ten lifestyle-based recommendations, including aspects related to body weight and composition, diet, alcohol intake, and physical activity, 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. We have previously reported associations between greater adherence to the Cancer Prevention Recommendations (i.e., a higher 218 WCRF/AICR Score) and lower risk of all cancers combined, 17 lifestyle-related cancers combined, and individual cancer sites such as pancreatic and breast cancer in the PLCO Cancer Screening Trial:
Malcomson FC, Shams-White MM, Reedy J, Huang WY, Moore SC, Loftfield E. Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations and risk of lifestyle-related cancers in the prostate, lung, colorectal, and ovarian cancer screening trial. BJC Rep. 2025 Nov 19;3(1):81. doi: 10.1038/s44276-025-00195-6. PMID: 41261199; PMCID: PMC12630754.
One of the ten WCRF/AICR Cancer Prevention Recommendations advises individuals “After a cancer diagnosis, follow our Recommendations, if you can”; however the evidence for associations between adherence to the Cancer Prevention Recommendations and risk of mortality in people diagnosed with cancer is limited.
Aims
The main aim of this study is to investigate associations between 2018 WCRF/AICR Score and the risk of all-cause and cause-specific (e.g., cancer-specific) mortality in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. The 2018 WCRF/AICR Score will be explored as a continuous variable (i.e., changes in risk per 1-point increment in Score) as well as categorical variable (i.e., using study-specific tertiles).
We will also explore associations between 2018 WCRF/AICR Score and mortality-related outcomes according to specific cancer sites.
We will further investigate whether these associations are modulated by factors such as sex, hormone use status (when applicable), and tumor histological grade.
Collaborators
Fiona Malcomson Newcastle University
Erikka Loftfield Queensland Institute of Medical Research
Wen-Yi Huang National Cancer Institute