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. 2017 Aug 30;17(1):597.
doi: 10.1186/s12885-017-3557-1.

Cancer-related risk factors and incidence of major cancers by race, gender and region; analysis of the NIH-AARP diet and health study

Tomi Akinyemiju  1   2   3 , Howard Wiener  4 , Maria Pisu  5   6
Affiliations

Cancer-related risk factors and incidence of major cancers by race, gender and region; analysis of the NIH-AARP diet and health study

Tomi Akinyemiju et al. BMC Cancer. .

Abstract

Background: Racial disparities in the incidence of major cancers may be attributed to differences in the prevalence of established, modifiable risk factors such as obesity, smoking, physical activity and diet.

Methods: Data from a prospective cohort of 566,398 adults aged 50-71 years, 19,677 African-American and 450,623 Whites, was analyzed. Baseline data on cancer-related risk factors such as smoking, alcohol, physical activity and dietary patterns were used to create an individual adherence score. Differences in adherence by race, gender and geographic region were assessed using descriptive statistics, and Cox proportional hazards models were used to determine the association between adherence and cancer incidence.

Results: Only 1.5% of study participants were adherent to all five cancer-related risk factor guidelines, with marked race-, gender- and regional differences in adherence overall. Compared with participants who were fully adherent to all five cancer risk factor criteria, those adherent to one or less had a 76% increased risk of any cancer incidence (HR: 1.76, 95% CI: 1.70 - 1.82), 38% increased risk of breast cancer (HR: 1.38, 95% CI: 1.25 - 1.52), and doubled the risk of colorectal cancer (HR: 2.06, 95% CI: 1.84 - 2.29). However, risk of prostate cancer was lower among participants adherent to one or less compared with those who were fully adherent (HR: 0.79, 95% CI: 0.75 - 0.85). The proportion of cancer incident cases attributable to low adherence was higher among African-Americans compared with Whites for all cancers (21% vs. 19%), and highest for colorectal cancer (25%) regardless of race.

Conclusion: Racial differences in the proportion of cancer incidence attributable to low adherence suggests unique opportunities for targeted cancer prevention strategies that may help eliminate racial disparities in cancer burden among older US adults.

Keywords: Cancer incidence; Cancer-related risk factors; Diet; Obesity; Physical activity.

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Conflict of interest statement

Authors’ information

NA.

Ethics approval and consent to participate

Informed consent was obtained from all study participants for the NIH-AARP study and this study was approved by the University of Alabama at Birmingham Institutional Review Board (Protocol #: E150623007).

Consent for publication

NA.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Distribution of adherence components by race and gender, stratified by region, NIH-AARP Diet and Health Study
Fig. 2
Fig. 2
Multivariable adjusted hazard ratios (HR, 95% CI) for adherence and cancer incidence, stratified by race, NIH-AARP Diet and Health Study
Fig. 3
Fig. 3
Attributable fraction (%, 95% CI) for adherence by race and cancer type
See this image and copyright information in PMC

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