TY - JOUR
T1 - Adherence to the American Cancer Society Guidelines on nutrition and physical activity for cancer prevention and obesity-related cancer risk and mortality in Black and Latina Women's Health Initiative participants
AU - Pichardo, Margaret S.
AU - Esserman, Denise
AU - Ferrucci, Leah M.
AU - Molina, Yamile
AU - Chlebowski, Rowan T.
AU - Pan, Kathy
AU - Garcia, David O.
AU - Lane, Dorothy S.
AU - Shadyab, Aladdin H.
AU - Lopez-Pentecost, Melissa
AU - Luo, Juhua
AU - Kato, Ikuko
AU - Springfield, Sparkle
AU - Rosal, Milagros C.
AU - Bea, Jennifer W.
AU - Cespedes Feliciano, Elizabeth M.
AU - Qi, Lihong
AU - Nassir, Rami
AU - Snetselaar, Linda
AU - Manson, Jo Ann
AU - Bird, Chloe
AU - Irwin, Melinda L.
N1 - Funding Information:
The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The development of this article is partially supported by the following grants: National Cancer Institute: R01CA119171, R01CA10921, R25CA203650, R01CA207753, R01CA251589, R01CA240394, K01CA226155; National Institute on Minority Health and Health Disparities grants: K01MD014761, F31MD016283; National institute of Aging: R01AG65334; Centers for Disease Control and Prevention: 1U48DP006381–03-01; the Yale Clinical and Translational Science Award: UL1 TR001863. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, 75N92021D00005, HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C. Secondary analysis of these data was approved by the Yale Human Investigations Committee (HIC#2000024871). We acknowledge the contributions of WHI investigators that have made this work possible. Program Office (National Heart, Lung, and Blood Institute, Bethesda, Maryland): Jacques Rossouw, Shari Ludlam, Joan McGowan, Leslie Ford, and Nancy Geller. Clinical Coordinating Center (Fred Hutchinson Cancer Research Center, Seattle, WA): Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kooperberg. Investigators and academic centers (Brigham and Women's Hospital, Harvard Medical School, Boston, MA): JoAnn E. Manson; (MedStar Health Research Institute/Howard University, Washington, DC): Barbara V. Howard; (Stanford Prevention Research Center, Stanford, CA): Marcia L. Stefanick; (The Ohio State University, Columbus, OH): Rebecca Jackson; (University of Arizona, Tucson/Phoenix, AZ): Cynthia A. Thomson; (University at Buffalo, Buffalo, NY): Jean Wactawski-Wende; (University of Florida, Gainesville/Jacksonville, FL): Marian Limacher; (University of Iowa, Iowa City/Davenport, IA): Jennifer Robinson; (University of Pittsburgh, Pittsburgh, PA): Lewis Kuller; (Wake Forest University School of Medicine, Winston-Salem, NC): Sally Shumaker; (University of Nevada, Reno, NV): Robert Brunner. Women's Health Initiative Memory Study (Wake Forest University School of Medicine, Winston-Salem, NC): Mark Espeland.
Funding Information:
Partially supported by the following grants: National Cancer Institute: R01CA119171, R01CA10921, R25CA203650, R01CA207753, R01CA251589, R01CA240394, K01CA226155; National Institute on Minority Health and Health Disparities grants: K01MD014761, F31MD016283; National institute of Aging: R01AG65334; Centers for Disease Control and Prevention: 1U48DP006381–03‐01; the Yale Clinical and Translational Science Award: UL1 TR001863. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, 75N92021D00005, HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C.
Funding Information:
The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The development of this article is partially supported by the following grants: National Cancer Institute: R01CA119171, R01CA10921, R25CA203650, R01CA207753, R01CA251589, R01CA240394, K01CA226155; National Institute on Minority Health and Health Disparities grants: K01MD014761, F31MD016283; National institute of Aging: R01AG65334; Centers for Disease Control and Prevention: 1U48DP006381–03‐01; the Yale Clinical and Translational Science Award: UL1 TR001863. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, 75N92021D00005, HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C. Secondary analysis of these data was approved by the Yale Human Investigations Committee (HIC#2000024871).
Publisher Copyright:
© 2022 American Cancer Society.
PY - 2022/10
Y1 - 2022/10
N2 - Background: Although adherence to the American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention associates with lower risk of obesity-related cancer (ORC) incidence and mortality, evidence in Black and Latina women is limited. This association was examined in Black and Latina participants in the Women's Health Initiative (WHI). Methods: Semi-Markov multistate model examined the association between ACS guideline adherence and ORC incidence and mortality in the presence of competing events, combined and separately, for 9301 Black and 4221 Latina postmenopausal women. Additionally, ACS guideline adherence was examined in a subset of less common ORCs and potential effect modification by neighborhood socioeconomic status and smoking. Results: Over a median of 11.1, 12.5, and 3.7 years of follow-up for incidence, nonconditional mortality, and conditional mortality, respectively, 1191 ORCs (Black/Latina women: 841/269), 1970 all-cause deaths (Black/Latina women: 1576/394), and 341 ORC-related deaths (Black/Latina women: 259/82) were observed. Higher ACS guideline adherence was associated with lower ORC incidence for both Black (cause-specific hazard ratio [CSHR]highvs.low: 0.72; 95% CI, 0.55–0.94) and Latina (CSHRhighvs.low: 0.58, 95% CI, 0.36–0.93) women; but not conditional all-cause mortality (Black hazard ratio [HR]highvs.low: 0.86; 95% CI, 0.53–1.39; Latina HRhighvs.low: 0.81; 95% CI, 0.32–2.06). Higher adherence was associated with lower incidence of less common ORC (Ptrend =.025), but conditional mortality events were limited. Adherence and ORC-specific deaths were not associated and there was no evidence of effect modification. Conclusions: Adherence to the ACS guidelines was associated with lower risk of ORCs and less common ORCs but was not for conditional ORC-related mortality. Lay summary: Evidence on the association between the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention and cancer remains scarce for women of color. Adherence to the guidelines and risk of developing one of 13 obesity-related cancers among Black and Latina women in the Women's Health Initiative was examined. Women who followed the lifestyle guidelines had 28% to 42% lower risk of obesity-related cancer. These findings support public health interventions to reduce growing racial/ethnic disparities in obesity-related cancers.
AB - Background: Although adherence to the American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention associates with lower risk of obesity-related cancer (ORC) incidence and mortality, evidence in Black and Latina women is limited. This association was examined in Black and Latina participants in the Women's Health Initiative (WHI). Methods: Semi-Markov multistate model examined the association between ACS guideline adherence and ORC incidence and mortality in the presence of competing events, combined and separately, for 9301 Black and 4221 Latina postmenopausal women. Additionally, ACS guideline adherence was examined in a subset of less common ORCs and potential effect modification by neighborhood socioeconomic status and smoking. Results: Over a median of 11.1, 12.5, and 3.7 years of follow-up for incidence, nonconditional mortality, and conditional mortality, respectively, 1191 ORCs (Black/Latina women: 841/269), 1970 all-cause deaths (Black/Latina women: 1576/394), and 341 ORC-related deaths (Black/Latina women: 259/82) were observed. Higher ACS guideline adherence was associated with lower ORC incidence for both Black (cause-specific hazard ratio [CSHR]highvs.low: 0.72; 95% CI, 0.55–0.94) and Latina (CSHRhighvs.low: 0.58, 95% CI, 0.36–0.93) women; but not conditional all-cause mortality (Black hazard ratio [HR]highvs.low: 0.86; 95% CI, 0.53–1.39; Latina HRhighvs.low: 0.81; 95% CI, 0.32–2.06). Higher adherence was associated with lower incidence of less common ORC (Ptrend =.025), but conditional mortality events were limited. Adherence and ORC-specific deaths were not associated and there was no evidence of effect modification. Conclusions: Adherence to the ACS guidelines was associated with lower risk of ORCs and less common ORCs but was not for conditional ORC-related mortality. Lay summary: Evidence on the association between the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention and cancer remains scarce for women of color. Adherence to the guidelines and risk of developing one of 13 obesity-related cancers among Black and Latina women in the Women's Health Initiative was examined. Women who followed the lifestyle guidelines had 28% to 42% lower risk of obesity-related cancer. These findings support public health interventions to reduce growing racial/ethnic disparities in obesity-related cancers.
KW - Black/African American
KW - Hispanic/Latina
KW - cancer risk
KW - lifestyle guidelines
KW - mortality
KW - obesity
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U2 - 10.1002/cncr.34428
DO - 10.1002/cncr.34428
M3 - Article
C2 - 35996861
AN - SCOPUS:85136503228
SN - 0008-543X
VL - 128
SP - 3630
EP - 3640
JO - Cancer
JF - Cancer
IS - 20
ER -