Abbreviated Score to Assess Adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations - Study Findings in the UK Biobank

Sep 21, 2026

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Background: World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations provide lifestyle-based guidance to reduce cancer risk. Objective: In the UK Biobank, the study evaluated whether an abbreviated adherence score is associated with the risk of all cancers combined and 14 cancers with strong evidence linking diet, adiposity, and physical activity. Methods: 288,802 cancer-free participants were analyzed using Cox proportional hazards models. Results: Greater adherence showed an inverse association with overall and multiple site-specific cancers.

LanguageEnglish

CategoryResearch & Report

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Pages10

Reading Time25 min

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Background

Methods

Results

Conclusions and Impact

Abbreviated Score to Assess Adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and Risk of Cancer in the UK Biobank Fiona C. Malcomson1,2, Solange Parra-Soto3,4,5, Frederick K. Ho4, Carlos Celis-Morales3,4,6, Linda Sharp2, and John C. Mathers1 ◥ Background: The World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations are lifestyle-based guidelines which aim to reduce cancer risk. This study investigated, in the UK Biobank, associations between an abbreviated score to assess adherence to these Recommendations and the risk of all cancers combined and of 14 cancers for which there is strong evidence for links with diet, adiposity, and physical activity. Methods: We used data from 288,802 UK Biobank participants (mean age 56.2 years), cancer-free at baseline. An abbreviated version of the 2018 WCRF/AICR Score was calculated to assess adherence toﬁve Recommendations on(i)bodyweight,(ii)physical activity, (iii) fruits, vegetables, and dietary ﬁber, (iv) red and processed meat, and (v) alcohol. Multivariable Cox proportional hazards models were used to analyze associations between the abbreviated score (range, 0–5 points) and cancer incidence, adjusting for confounders. Results: During a median follow-up of 8.2 years (interquartile range, 7.4–8.9), 23,448 participants were diagnosed with cancer. The abbreviated score was inversely associated with risk of cancer overall [HR: 0.93; 95% conﬁdence interval (CI): 0.92–0.95 per 1-point increment], and breast (HR: 0.90; 95% CI: 0.87–0.94), colorectal (HR: 0.86; 95% CI: 0.83–0.90), lung (HR: 0.89; 95% CI: 0.84–0.94), kidney (HR: 0.83; 95% CI: 0.76–0.90), pancreatic (HR: 0.86; 95% CI: 0.79–0.94), uterine (HR: 0.79; 95% CI: 0.73–0.86), esophageal (HR: 0.82; 95% CI: 0.75–0.90), stomach (HR: 0 . 89; 95% CI: 0 .79–0.99), and liver (HR: 0 . 80; 95% CI: 0 .72– 0. 90) cancers. Conclusions: Greater adherence to the Cancer Prevention Recommendations, assessed using an abbreviated score, was associated with reduced risk of all cancers combined and of nine sitespeciﬁc cancers. Impact: Our ﬁndings support compliance to these Recommendations for cancer prevention. Introduction The risk of developing several common cancers is modulated by lifestyle factors including diet, physical activity, and body weight and composition and, in the United Kingdom, approximately 40% of all cancers are attributable to such factors (1) . The World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations aim to promote a healthier lifestyle and reduce the risk of cancer (2) . Following the publication of the latest update to the recommendations in 2018, a scoring system, known as the “2018 1Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom. 2Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom. 3School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom. 4School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom. 5Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile. 6Human Performance Lab, Education, Physical Activity and Health Research Unit, University Cat . Corresponding Author: John C. Mathers, Human Nutrition & Exercise Research Centre, Newcastle University, Population Health Sciences Institute, Newcastle NE2 4HH, United Kingdom. E-mail: [john.mathers@newcastle.ac.uk](john.mathers@newcastle.ac.uk) [Cancer Epidemiol Biomarkers Prev 2024](Cancer Epidemiol Biomarkers Prev 2024);[33:33](33:33)–[42](42) [doi:](doi: 10.1158/1055-9965.EPI-23-0923)[ 10.1158/1055-9965.EPI-23-0923](doi: 10.1158/1055-9965.EPI-23-0923) This open access article is distributed under the Creative Commons AttributionNonCommercial-NoDerivati

FAQs

What was the purpose of developing an abbreviated WCRF/AICR score in the UK Biobank study?

To quantify adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations using an abbreviated scoring approach and to test whether higher adherence relates to cancer risk.

Which lifestyle components were included in the abbreviated score?

The score assessed adherence across five recommendations: bodyweight, physical activity, fruits/vegetables and dietary fiber, red and processed meat, and alcohol.

What did the study find about the relationship between the abbreviated adherence score and cancer risk?

Higher adherence was inversely associated with the risk of cancer overall and with several site-specific cancers, including breast, colorectal, lung, and others.

Sep 21, 2026

Uploaded by Jiven