Abstract 1744: Is adherence to the WCRF/AICR cancer prevention recommendations associated with colorectal cancer in African American women in the Black Women's Health Study
Authors: Nomura Sarah J. O. , Dash Chiranjeev , Rosenberg Lynn , Yu Jeffrey , Palmer Julie R. , Adams-Campbell Lucile L. 
Published: July 2016

Background: African American women are more likely to be diagnosed with colorectal cancer than women from other racial/ethnic groups. Differences in adherence to cancer prevention recommendations may contribute to disparities. Adherence to cancer prevention guidelines has previously been shown to be associated with lower breast cancer incidence, but previous study populations have included few African Americans.

Objective: The purpose of this study was to evaluate adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and colorectal cancer incidence in the Black Women's Health Study (BWHS).

Methods: In this ongoing prospective cohort of African American women (analytic cohort N = 49,103), 354 incident colorectal cancers were diagnosed between baseline (1995) and 2011. Adherence scores for seven WCRF/AICR recommendations (adherent = 1 point, non-adherence level 1 = 0.5 points, non-adherence level 2 = 0 points) were created using questionnaire data and summed to an overall adherence score (maximum = 7). Diet-specific recommendations were additionally summed for a diet only score (maximum = 5). Recommendation adherence and incidence of colorectal cancer combined and colon cancer only were evaluated using baseline and time-varying data in Cox regression models.

Results: Guideline adherence was low with 8.5% of women (5.6% among women who later developed colorectal cancer) adhering to more than four recommendations at baseline. Adherence to a greater number of WCRF/AICR recommendations was not statistically significantly associated with colorectal cancer risk in time-varying or baseline models. In time-varying analyses, the HR (per 0.5 point increase) was 0.98 (95% CI: 0.84-1.15) and 0.51 (95% CI: 0.23-1.10) among women who adhered to &gt;4 compared to &lt;3 recommendations. Similarly, colon cancer evaluated alone was not statistically significantly associated with breast cancer incidence in time-varying (&gt;4 vs. &lt;3 recommendations HR = 0.54, 95% CI: 0.23-1.26) or baseline models (&gt;4 vs. &lt;3 recommendations HR = 0.72, 95% CI: 0.39-1.34). Regardless of modeling approach, adherence to dietary recommendations or individual recommendations was not associated with colon only or combined colorectal cancer risk.

Conclusions: Further research in diverse populations is essential to evaluate the validity of existing recommendations, and to assess whether there are alternative recommendations that are more beneficial for colorectal cancer prevention in specific populations.

Citation Format: Sarah J. O. Nomura, Chiranjeev Dash, Lynn Rosenberg, Jeffrey Yu, Julie R. Palmer, Lucile L. Adams-Campbell. Is adherence to the WCRF/AICR cancer prevention recommendations associated with colorectal cancer in African American women in the Black Women's Health Study. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1744.