Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention is associated with better health-related quality of life among long-term colorectal cancer survivors: results of the PROFILES registry

Since colorectal cancer (CRC) survivors often suffer from long-term adverse health effects of the cancer and its treatment, having a negative impact on their health-related quality of life (HRQL), this study focuses on the association between adherence to WCRF/AICR recommendations and HRQL among CRC survivors. In a cross-sectional PROFILES registry study in 1096 CRC survivors (mean time since diagnosis 8.1 years), WCRF/AICR adherence scores (range 0-8, with a higher score for better adherence) were calculated, and HRQL was assessed using the EORTC QLQ-C30. Associations between adherence scores and HRQL scores were investigated using linear regression analyses. Additionally, associations with adherence to guidelines for body mass index (BMI) (normal weight, overweight and obese), physical activity (PA) (score 0/1) and diet (score 4) were evaluated separately. Mean adherence score was 4.81 +/- 1.04. Higher WCRF/AICR scores were associated with better global health status (beta 1.64; 95%CI 0.69/2.59), physical functioning (beta 2.71; 95%CI 1.73/3.68), role functioning (beta 2.87; 95%CI 1.53/4.21), cognitive functioning (beta 1.25; 95%CI 0.19/2.32), social functioning (beta 2.01; 95%CI 0.85/3.16) and fatigue (beta - 2.81; 95%CI - 4.02/- 1.60). Adherence versus non-adherence PA was significantly associated with better physical, role, emotional and social functioning, global health status and less fatigue. Except for the association between being obese and physical functioning (beta - 4.15; 95%CI - 47.16/- 1.15), no statistically significant associations with physical functioning were observed comparing adherence to non-adherence to BMI and dietary recommendations. Better adherence to the WCRF/AICR recommendations was positively associated with global health status, most functioning scales and less fatigue among CRC survivors. PA seemed to be the main contributor