Abstract 2303: The impact of adherence to cancer prevention guidelines on cancer risk, cancer incidence and mortality in a large cohort of Canadian adults

Abstract Background: The World Cancer Research Fund (WCRF) and the American Institute of Cancer Research (AICR) publish behavioral guidelines for cancer prevention. The guidelines provide standards on body weight, physical activity, diet, alcohol consumption, and smoking. This study examined the impact of adherence to these guidelines on cancer incidence and mortality in a large cohort of Canadian adults. Methods: Data were obtained from the British Columbia Generations Project (BCGP), a longitudinal cohort of 30, 000 adults aged 35-69 years recruited between 2009 and 2015, with a median follow-up of 10 years. Participants with a baseline cancer diagnosis were excluded, leaving 23, 482 eligible individuals. A 3-level adherence score was constructed for each guideline. Cox proportional hazard models were employed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for cancer incidence and mortality, adjusting for sociodemographic and health covariates. Propensity score matching was conducted to assess the robustness of the results. Results: 3, 068 new cancer cases and 769 cancer deaths were recorded during follow-up. Full adherence to the WCRF/AICR guidelines was achieved by only 19% of men and 31% of women. High adherence was associated with a significant reduction in all cancer incidence, with HRs of 0.81 (95% CI: 0.68-0.92) for women and 0.82 (95% CI: 0.73-0.95) for men. Cancer mortality was also lower among adherent individuals, with HRs of 0.83 (95% CI: 0.66-1.09) for women and 0.86 (95% CI: 0.70-0.96) for men. Additionally, total mortality decreased by 14% in women (HR = 0.86; 95% CI: 0.69-0.95) and 11% in men (HR = 0.89; 95% CI: 0.72-0.93). These associations remained robust after adjusting for sociodemographic and health covariates and were confirmed through propensity score matching. Conclusions: Adherence to cancer prevention guidelines was associated with lower cancer incidence and mortality in both men and women. These findings highlight the importance of lifestyle modifications to reduce cancer risk among Canadian adults. Citation Format: Samuel S. Fiati-Kenston, Rachel A. Murphy, Jerry M. Spiegel, Trevor J. Dummer. The impact of adherence to cancer prevention guidelines on cancer risk, cancer incidence and mortality in a large cohort of Canadian adults [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 2303.