背景:尽管遵守美国癌症协会(ACS)关于癌症预防的营养和身体活动指南与降低肥胖相关癌症(ORC)发病率和死亡率的风险相关,黑人和拉丁裔妇女的证据有限。在妇女健康倡议(WHI)的黑人和拉丁裔参与者中检查了这种关联。
方法:半马尔可夫多状态模型检查了在存在竞争性事件的情况下ACS指南依从性与ORC发生率和死亡率之间的关联。合并和单独,9301名黑人和4221名拉丁裔绝经后妇女。此外,在较不常见的ORC子集中检查了ACS指南的依从性,并通过邻里社会经济状况和吸烟对潜在影响进行了修改。
结果:平均随访11.1、12.5和3.7年的发病率,非条件死亡率,和有条件的死亡率,分别,1191个ORC(黑人/拉丁裔妇女:841/269),1970年全因死亡(黑人/拉丁裔妇女:1576/394),观察到341例ORC相关死亡(黑人/拉丁裔女性:259/82)。较高的ACS指南依从性与两种Black的ORC发生率较低相关(原因特异性风险比[CSHR]高vs.低:0.72;95%CI,0.55-0.94)和拉丁裔(CSHRhighvs。低:0.58,95%CI,0.36-0.93)女性;但不是有条件的全因死亡率(黑色风险比[HR]高vs.低:0.86;95%CI,0.53-1.39;拉丁裔HRhighvs。低:0.81;95%CI,0.32-2.06)。较高的依从性与较不常见ORC的较低发生率相关(Ptrend=0.025),但条件性死亡事件有限.依从性和ORC特异性死亡没有相关性,也没有效果改变的证据。
结论:遵循ACS指南与ORC的风险较低和ORC的发生率较低相关,但与条件ORC相关死亡率无关。
背景:关于美国癌症协会营养和身体活动预防癌症指南与癌症之间关联的证据对于有色人种女性仍然很少。在妇女健康倡议中,对黑人和拉丁裔妇女中13种肥胖相关癌症的依从性和风险进行了检查。遵循生活方式指南的女性患肥胖相关癌症的风险降低28%至42%。这些发现支持公共卫生干预措施,以减少肥胖相关癌症中日益增长的种族/族裔差异。
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).
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.
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.
Adherence to the ACS guidelines was associated with lower risk of ORCs and less common ORCs but was not for conditional ORC-related mortality.
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.