Cancer Causes & Control

, Volume 25, Issue 5, pp 541–552

Adherence to the WCRF/AICR cancer prevention recommendations and cancer-specific mortality: results from the Vitamins and Lifestyle (VITAL) Study

  • Theresa A. Hastert
  • Shirley A. A. Beresford
  • Lianne Sheppard
  • Emily White
Original paper

DOI: 10.1007/s10552-014-0358-6

Cite this article as:
Hastert, T.A., Beresford, S.A.A., Sheppard, L. et al. Cancer Causes Control (2014) 25: 541. doi:10.1007/s10552-014-0358-6



In 2007, the World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) released eight recommendations related to body fatness, physical activity, and diet aimed at preventing the most common cancers worldwide. The purpose of this paper is to estimate the association between meeting these recommendations and cancer-specific mortality.


We operationalized six recommendations (related to body fatness; physical activity; and consumption of foods that promote weight gain, plant foods, red and processed meat, and alcohol) and examined their association with cancer-specific mortality over 7.7 years of follow-up in the Vitamins and Lifestyle (VITAL) Study cohort. Participants included 57,841 men and women ages 50–76 in 2000–2002 who had not been diagnosed with cancer prior to baseline. Cancer-specific deaths (n = 1,595) were tracked through the Washington State death file.


Meeting the recommendations related to plant foods and foods that promote weight gain were most strongly associated with lower cancer-specific mortality [hazard ratio (HR) 0.82, 95 % confidence interval (CI) 0.67, 1.00 and HR 0.82, 95 % CI 0.70, 0.96, respectively]. Cancer-specific mortality was 61 % lower in respondents who met at least five recommendations compared to those who met none (HR 0.39, 95 % CI 0.24, 0.62). Cancer-specific mortality was 10 % lower on an average with each additional recommendation met (per-recommendation HR 0.90, 95 % CI 0.85, 0.94; ptrend < 0.001). This association did not differ by sex or age but was stronger in non-smokers (HR 0.84, 95 % CI 0.76, 0.92) than in smokers (HR 0.93, 95 % CI 0.87, 0.98; pinteraction = 0.086).


Adherence to the WCRF/AICR cancer prevention recommendations developed to reduce incidence of common cancers could substantially reduce cancer-specific mortality in older adults.


AlcoholCancer-specific mortalityCancer preventionDietPhysical activityRecommendations



World Cancer Research Fund


American Institute for Cancer Research

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Theresa A. Hastert
    • 1
    • 2
    • 3
  • Shirley A. A. Beresford
    • 1
    • 2
  • Lianne Sheppard
    • 4
    • 5
  • Emily White
    • 1
    • 2
  1. 1.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  2. 2.Fred Hutchinson Cancer Research CenterSeattleUSA
  3. 3.Center for Social Epidemiology and Population HealthUniversity of Michigan School of Public HealthAnn ArborUSA
  4. 4.Department of Environmental and Occupational Health SciencesUniversity of WashingtonSeattleUSA
  5. 5.Department of BiostatisticsUniversity of WashingtonSeattleUSA