Abstract 2277: Adherence to cancer prevention guidelines and risk of cancer among older white and black adults in the Health ABC Study
Authors: Jung Audrey Y. , Gu Christina , Milijkovic Iva , Rubin Susan , Satterfield Suzanne , Kritschevsky Stephen B. , Klepin Heidi , Newman Anne B. , Cauley Jane , Ayonayon Hilsa , Harris Tamara B. , Murphy Rachel A. 
Published: July 2017

Abstract
Background: About one-third of cancers can be prevented by healthy lifestyle behaviors. The American Cancer Society (ACS) have guidelines for reducing the risk of cancer by maintaining a healthy body weight, being physically active, eating well and limiting alcohol. Few studies have examined adherence to cancer preventive behavior and subsequent cancer risk in older populations that are inclusive of men, women and minorities.
Methods: We evaluated adherence to ACS cancer prevention guidelines and subsequent risk of all incident cancer in the Health, Aging and Body Composition Study. The population included 2,124 white and black men and women aged 71-80 years who were initially free of cancer at baseline (1998-1999). Adherence to ACS guidelines was scored from 0 (lowest adherence) to 8 (greatest adherence). Maintenance of healthy body weight was determined from body mass index at ages 25 and 50 (recalled at baseline) and measured height and weight at baseline. Physical activity and alcohol intake were assessed by questionnaire. Diet was assessed by food frequency questionnaire (servings of fruits and vegetables, the ratio of whole grains to refined grains and intake of red meat and processed meats). Incident cancer (all types except non-melanoma skin cancer) was confirmed from pathology reports when available, or medical records and death certificates. Risk of cancer was determined with cox regression adjusted for gender, age and study site. Participants with the lowest adherence to ACS guidelines were the referent.
Results: The lowest adherence category (scores 0-2) had 297 participants (14% of all participants), 1,316 (62%) were in the moderate adherence category (scores 3-5), and 511 (24%) were in the highest adherence category (scores 6-8). Adherence was lower among men (P&lt;0.001), black (P&lt;0.001) and older participants (P&lt;0.01). After a median follow-up of 12.5 years, 517 people developed incident cancer. Participants with moderate adherence had a 23% lower risk of cancer [HR=0.77, 95% CI=0.60-0.97]. Participants with the greatest adherence had a 26% lower risk of cancer [HR=0.74, 95% CI=0.56-0.98].
Conclusions: Only 1 in 4 older adults closely followed healthy lifestyle behaviors outlined by the ACS for cancer prevention. Greater adherence to recommendations was associated with lower likelihood of total cancer in older white and black adults. Public health efforts to increase preventive lifestyle behaviors may be particularly needed among men, black and older individuals.
Citation Format: Audrey Y. Jung, Christina Gu, Iva Milijkovic, Susan Rubin, Suzanne Satterfield, Stephen B. Kritschevsky, Heidi Klepin, Anne B. Newman, Jane Cauley, Hilsa Ayonayon, Tamara B. Harris, Rachel A. Murphy. Adherence to cancer prevention guidelines and risk of cancer among older white and black adults in the Health ABC Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2277. doi:10.1158/1538-7445.AM2017-2277