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

Simple Summary There is insufficient evidence on the impact of sociodemographic and clinical factors on health-related lifestyles in breast cancer (BC) survivors. The International guidelines for cancer prevention are recommended not only for the general population but also for people who already have cancer. We sought to explore the degree of adherence to 2018 WCRF/AICR cancer prevention recommendations and to identify potentially influential factors, in 420 BC survivors in Spain. Global adherence was moderate, higher for the consumption of fruits and vegetables and lower for limiting red/processed meat consumption and having a high fibre intake. Compliance was worse in more educated survivors and in women with first-degree relatives with BC. There were differences in compliance with specific recommendations according to sociodemographic and clinical characteristics. This information is of interest to promote behavioural changes towards healthier lifestyles in BC survivors. 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.

Automated summary

The study found that compliance with cancer prevention recommendations among breast cancer survivors is generally low, particularly in terms of limiting consumption of red/processed meats and high fiber intake. Compliance is worse among women with higher education levels and those with first-degree relatives with breast cancer. This information is helpful for designing personalized preventive measures.