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. 2022 Sep 27;14(19):4705.
doi: 10.3390/cancers14194705.

Clinical and Sociodemographic Determinants of Adherence to World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Recommendations in Breast Cancer Survivors-Health-EpiGEICAM Study

Virginia Lope  1   2   3 , Angel Guerrero-Zotano  3   4 , Emma Ruiz-Moreno  1   2 , Begoña Bermejo  3   5   6   7 , Silvia Antolín  3   8 , Álvaro Montaño  3   9 , José Manuel Baena-Cañada  3   10 , Manuel Ramos Vázquez  3   11 , Nerea Fernández de Larrea-Baz  1   2   3 , José Ignacio Chacón  3   12 , José Angel García-Sáenz  3   6   13 , Clara Olier  3   14 , Montserrat Muñoz  3   15 , Antonio Antón  3   16 , Pedro Sánchez Rovira  3   17 , Angels Arcusa Lanza  3   18 , Sonia González  3   19 , Amparo Oltra  3   20 , Joan Brunet  3   21 , Joaquín Gavilá Gregori  3   4 , María Teresa Martínez  3   5 , Lourdes Calvo  3   8 , Libertad Rosell  3 , Susana Bezares  3 , Roberto Pastor-Barriuso  1   2 , Beatriz Pérez-Gómez  1   2   3 , Miguel Martín  3   6   22 , Marina Pollán  1   2   3
Affiliations

Clinical and Sociodemographic Determinants of Adherence to World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Recommendations in Breast Cancer Survivors-Health-EpiGEICAM Study

Virginia Lope et al. Cancers (Basel). .

Abstract

Breast cancer (BC) survivors are advised to follow the WCRF/AICR cancer prevention recommendations, given their high risk of developing a second tumour. We aimed to explore compliance with these recommendations in BC survivors and to identify potentially associated clinical and sociodemographic factors. A total of 420 BC survivors, aged 31-80, was recruited from 16 Spanish hospitals. Epidemiological, dietary and physical activity information was collected through questionnaires. A 7-item score to measure compliance with the recommendations was built according to the 2018 WCRF/AICR scoring criteria. Standardized prevalences and standardized prevalence ratios of moderate and high compliance across participant characteristics were estimated using multinomial and binary logistic regression models. The mean score was 3.9 (SD: 1.0) out of 7 points. Recommendations with the worst adherence were those of limiting consumption of red/processed meats (12% of compliance, 95% CI: 8.2-15.0) and high fibre intake (22% of compliance, 95% CI: 17.6-27.0), while the best compliance was observed for the consumption of fruits and vegetables (73% of compliance, 95% CI: 69.2-77.7). Overall, adherence was worse in women with university education and in those with first-degree relatives with BC. This information may be of interest to design and implement personalized preventive measures adapted to the characteristics of these patients.

Keywords: Health-EpiGEICAM; WCRF/AICR guidelines; breast cancer; cancer prevention recommendations; compliance; health behaviours; healthy lifestyle; lifestyle recommendations; survival.

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Conflict of interest statement

A.G.-Z. received institutional grants from Pfizer; advisory board fees from Novartis, Palex, Pfizer, Astra Zeneca and Pierre Fabre; travel grants from Pfizer and Novartis; speaker honoraria from Novartis, Pierre Fabre, Lilly, Pfizer and Astra Zeneca. J.A.G.-S. received consultative and advisory board fees for Seagen, Gilead and Sanofi; consultancy/speaker fees from Novartis, Celgene, Eli Lilly, EISAI, AstraZeneca, Daiichi Sankyo and MSD. M.M. (Montserrat Muñoz) received expert testimony honoraria from Novartis, Roche and Eisai; advisory board honoraria from Pierre Fabre and Seagen; travel grants from Roche, Pfizer and Lilly. J.G.G. received honoraria from Pfizer, Novartis, Lilly and Roche; travel grants from Roche; consultant fees from Pfizer, Novartis, Lilly and MSD; and speaker bureau fees for Novartis and Pfizer, during the study. The rest of the authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Standardised prevalence of high compliance with specific lifestyle recommendations by sociodemographic and clinical characteristics of breast cancer survivors (%). Standardised prevalence (95% CI) to the overall distribution of age, recruiting region, educational level, marital status, currently working, currently smoking, caloric intake, parity, family history of breast cancer, number of comorbidities, menopausal status at diagnosis, years since diagnosis, tumour subtype, AJCC stage at diagnosis, current cancer treatment and the overall adherence to the other recommendations in the entire sample of breast cancer survivors.
Figure 2
Figure 2
Standardised prevalence of high compliance with specific dietary recommendations by sociodemographic and clinical characteristics of breast cancer survivors (%). Standardised prevalence (95% CI) to the overall distribution of age, recruiting region, educational level, marital status, currently working, currently smoking, caloric intake, parity, family history of breast cancer, number of comorbidities, menopausal status at diagnosis, years since diagnosis, tumour subtype, AJCC stage at diagnosis, current cancer treatment and the overall adherence to the other recommendations in the entire sample of breast cancer survivors.
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