Cross-sectional and longitudinal associations of adherence to WCRF/AICR cancer prevention recommendations with health-related quality of life in breast cancer survivors. Health-EpiGEICAM study

J Nutr Health Aging. 2024 Aug;28(8):100312. doi: 10.1016/j.jnha.2024.100312. Epub 2024 Jul 5.

Abstract

Objectives: Adherence to healthy lifestyle recommendations has been reported to improve health-related quality of life (HRQL) in breast cancer (BC) patients, but the influence of long-term behavioral changes remains unknown. We evaluated the association between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and HRQL both, at BC diagnosis and the change 7-12 years later.

Design: Prospective cohort study.

Settings and participants: A total of 406 breast cancer survivors, from the EpiGEICAM study, were recruited in 16 Spanish hospitals.

Measurements: Epidemiological, clinical, dietary, physical activity and HRQL information was collected both at recruitment and 7-12 years later. A 7-item score to measure compliance with recommendations was assessed according to the 2018 WCRF/AICR scoring criteria. HRQL was evaluated using SF-36 questionnaire. Linear mixed models for longitudinal data were used to assess the cross-sectional and longitudinal association between adherence score and the physical and mental component summary scores.

Results: At diagnosis, for each unit increase in WCRF/AICR score adherence, the HRQL physical domain increased 0.78 points (95%CI: -0.04 to 1.60; P trend:0.06). The mean change in physical HRQL from diagnosis to follow-up per unit increase in within-subject adherence score was 0.73 points (95%CI: -0.18 to 1.65; P trend: 0.12). For the mental domain, no association was observed with compliance with the recommendations at diagnosis, nor with changes in adherence over time.

Conclusions: Our results suggest that Increased adherence to WCRF/AICR cancer prevention recommendations over time could contribute to slightly improved long-term physical HRQoL in BC survivors.

Keywords: Breast cancer survivors; Cancer prevention guidelines; Health behaviors; Health-related quality of life; WCRF/AICR recommendations.

MeSH terms

  • Aged
  • Breast Neoplasms* / prevention & control
  • Cancer Survivors* / psychology
  • Cancer Survivors* / statistics & numerical data
  • Cross-Sectional Studies
  • Exercise
  • Female
  • Healthy Lifestyle
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Patient Compliance / statistics & numerical data
  • Prospective Studies
  • Quality of Life*
  • Spain / epidemiology
  • Surveys and Questionnaires