AICR Recommendations & Cancer Prevention

For over a decade, researchers have investigated the effect of AICR’s Cancer Prevention Recommendations on cancer risk and other health measures. These studies, published in scientific journals, all start with specific groups of people who enter the study cancer-free. The studies then determine how each person’s adherence to the recommendations links to certain health outcomes over time.

Many of these papers have focused on breast and colon cancers, two of the most common types of tumors. Research suggests findings on these common cancers may apply to many other tumors; research is ongoing for these and other cancer types.  

Overall Risk Reduction & a Longer Life

  • One of the most recent studies, published in 2020, included approximately 54,000 men and women from Sweden. The study scored each person’s adherence to AICR’s 2018 recommendations and how that linked to cancer incidence over about 15 years. The paper concluded that adherence to AICR’s 2018 recommendations substantially reduced the risk of total cancer, with greater adherence leading to lower risk.

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  • According to a large study published in the American Journal of Clinical Nutrition, following the recommendations can help people live longer. The study included almost 379,000 Europeans who entered the study in the 1990s. After a median follow-up of 13 years, those who adhered to AICR’s recommendations the most had a 34 percent lower risk of dying during that time compared to those who least adhered to the recommendations. Lower risk was found for dying from cancer, circulatory disease, and respiratory disease.

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  • A paper published in Cancer Epidemiology, Biomarkers & Prevention sought to answer whether AICR’s dietary recommendations applied to older people. The study analyzed data from approximately 360,000 participants who were part of seven population studies across Europe and the United States. All were over 60 and cancer-free when they entered their study. Each person was scored on his/her adherence to four dietary-focused recommendations. After a median of 11 to 15 years across the studies, this analysis found that the more people adhered to the dietary recommendations the lower their cancer risk.

The paper concluded that the risk of cancer could be postponed by about 1.6 years in those ages 60 and above for each additional WCRF/AICR dietary recommendation followed.

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  • Adhering to AICR’s recommendations can help people avoid premature death and specifically, dying from cancer, reported a study in 2016. This paper included data from close to 17,000 Swiss adults who were between the ages of 25 and 74 when they joined one of two studies. Using census records to track mortality, the paper found that participants who reported adhering the most to AICR’s recommendations had a lower risk of dying from any cause during the 22-year follow-up when compared to those who least followed the recommendations. The study concluded that lower risk of dying from cancer was found among men and if lifestyle score levels had been higher, an estimated 13 percent of premature cancer deaths in men could be preventable.

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  • AICR’s Cancer Prevention Recommendations was one of four dietary/lifestyle recommendations tested for its association to cancer prevention in a 2018 paper published in Cancer Research. With almost 42,000 participants, this study scored how participants adhered to each set of recommendations. Study participants, who were all over the age of 40, were part of a French, web-based study and they supplied lifestyle and other data from 2009 to 2017. All four of the nutrition/lifestyle recommendations lowered cancer risk to some extent, but the paper concluded that the AICR score performed best. Better adherence to AICR’s recommendations contributes to lower overall cancer incidence, along with reduced breast and prostate cancers.

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  • A 2016 study pulled together twelve previous papers that had each looked at adherence to cancer prevention guidelines for diet and physical activity, which included AICR’s recommendations. Each of the studies had then collected data on how adherence related to overall cancer incidence and mortality. Based on all the studies, the paper concluded that the highest adherence to the cancer prevention recommendations was “consistently and significantly associated with 10-61 percent lower risk of cancer incidence and mortality” compared to those who least followed the recommendations.

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Impact on Specific Cancer Risk

  • AICR’s recommendations lower risk of colorectal cancer among both men and women, according to a paper published in Cancer Causes Control. This study scored how much approximately 67,000 participants reported adhering to six AICR recommendations. The participants were ages 70 to 76 when they entered the study and had no history of colorectal cancer. After an average of 7.6 years, those who met four to six recommendations had a 58 percent lower risk of developing colorectal cancer compared to those who did not adhere to any of the recommendations.

Meeting one to three recommendations lowered risk from 34 to 45 percent. The recommendations most strongly associated with lower colorectal cancer risk included those related to body fatness for women and alcohol for men.

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  • Much of the research related to AICR’s recommendations includes white participants. A 2019 paper published in Cancer investigated if adhering to AICR’s recommendations linked to colorectal cancer prevention among both whites and African Americans. Almost 14,000 people were part of the study, with about a quarter of the participants being African American. Greater adherence to the recommendations was associated with decreased colorectal cancer risk among the entire group, with similar lower risk found among the white and the African American participants.

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  • Another study that investigated AICR’s recommendations, colorectal cancer and African Americans focused on about 49,000 women who were part of the Black Women’s Health Study. The women had all provided information on their diet, activity and other lifestyle habits when they entered the study in the mid-1990s, which they updated throughout the years. The authors scored how much each woman adhered to seven AICR recommendations.

After an average of 15 years, the study did not find an association between following AICR’s recommendations and developing colorectal cancer. These results are inconsistent with other findings, the authors note, and the low adherence likely contributed. Less than one of ten women followed over four AICR recommendations.

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  • A 2016 study that reviewed 12 previous papers concluded that following cancer prevention guidelines, which included AICR’s recommendations, linked to lower risk of cancer incidence and mortality in general. This paper found the greatest amount of evidence related to breast cancer, with seven of eight studies showing a reduced risk associated with adhering to the recommendations. The studies with breast cancer all included women ages 50 and older.

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  • Investigating whether following AICR’s recommendations linked to lower risk of breast cancer was the focus of another 2016 paper, with the conclusion finding that they do. This paper scored lifestyle data from approximately 31,500 Swedish women who were primarily post-menopausal. After 15 years of follow-up, the study found that women who met six to seven recommendations had a 51 percent lower risk of breast cancer compared to women meeting zero to two recommendations. For the most common breast tumor types, ER‐positive/PR‐positive, there was an association between meeting each additional recommendation and lower breast cancer risk.

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  • There are some risk factors for breast cancer that a woman cannot change, such as being tall or family history. Published in the International Journal of Cancer, a study suggests that women who adhere to AICR’s recommendations the most are at a lower risk of breast cancer – whether they have non-modifiable risk factors or not. The study used data from about 36,000 postmenopausal women from the Iowa Women’s Health Study who were scored on their adherence to the recommendations.

Overall, women who followed six or more recommendations had a lower risk of developing breast cancer compared to women who followed three and a half  recommendations or fewer. Women who were relatively tall and had no children – risk factors for breast cancer — had similar benefits of adhering to the recommendations compared to shorter women and those with two children. The link among women having other non-modifiable risk factors, such as a family history of breast cancer, pointed to the benefits of meeting the recommendations but was not as clear.

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  • Pancreatic cancer is one of the less common types of cancer, but it is often not diagnosed until it’s in the advanced stages. In the first independent study focusing on whether the current AICR recommendations can lower pancreatic cancer risk in the US, the paper found that meeting the recommendations can both reduce risk of developing and dying from this cancer. This study used data from close to 96,000 participants who had joined a large trial between 1993 and 2001 where they answered questions about their diet and other lifestyle habits. Follow-up for incidence ended in 2009 and for mortality in 2015.

The authors found that the recommendation to be physically active was a key contributor to the lower risk for both incidence and mortality. The 2020 paper was published in Cancer Medicine.

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*In 2018 AICR updated our recommendations; meaning the majority of published papers used the 2007 Cancer Prevention Recommendations.