Adherence to cancer prevention recommendations is associated with a lower breast cancer risk in black urban South African women

Abstract

Breast cancer prevention is of great importance to reduce high incidence in South Africa. This study aimed to investigate adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and the association with breast cancer risk in black urban women from Soweto, South Africa. A total of 396 breast cancer cases and 396 population-based controls from the South African Breast Cancer study (SABC) matched on age and demographic settings was included. Validated questionnaires were used to collect dietary and epidemiological data. To assess adherence to these recommendations, an 8-point adherence score was developed, using tertiles among controls for scoring each recommendation (0, 0.5 and 1) with zero indicating the lowest adherence to the recommendations. Odds ratios and 95% confidence intervals were estimated using multivariate logistic regression models to analyse associations between the WCRF/AICR score and breast cancer risk. Greater adherence (>4.5 vs <3.25) to the 2018 WCRF/AICR Cancer Prevention Recommendations was associated with a significant inverse association with breast cancer risk overall (OR=0.54, 95%CI:0.35-0.91) and specifically in postmenopausal women (OR=0.55, 95%CI:0.34-0.95), in cases with oestrogen positive (ER+) and progesterone positive (PR+) breast cancer subtypes (OR=0.54, 95%CI:0.39-0.89 and OR=0.68, 95%CI:0.43-0.89, respectively), and in obese women (OR=0.52, 95%CI:0.35-0.81). No significant association with breast cancer risk was observed in premenopausal women. Greater adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations may reduce breast cancer risk in this black urban population of Soweto. Adherence thereof should be encouraged and form part of cost-effective breast cancer prevention guidelines.

Adherence to the South African food based dietary guidelines may reduce breast cancer risk in black South African women: the South African Breast Cancer (SABC) study

“…Furthermore, results of our study are in line with a recent study, conducted in the same black female population of Soweto, South Africa, which investigated the association between adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and breast cancer risk (10) . Both sets of recommendations showed that higher consumption of fruit and vegetables may reduce breast cancer risk in this population.…”

“…A similar study, conducted in black women from Soweto, South Africa, recently showed that higher adherence to the 2018 World Cancer Research Fund/American Institution for Cancer Research's (WCRF/AICR) Cancer Prevention Recommendations was associated with a lower breast cancer risk in this population (10) . Although the SAFBDG promote similar dietary guidelines as the 2018 WCRF/AICR Cancer prevention guidelines (i.e.…”

Degree of food processing and breast cancer risk in black urban women from Soweto, South African: the South African Breast Cancer study

“…Life size colour photographs of thirty-seven foods (in three portion sizes) were displayed in the food portion picture booklet (32) . A detailed description of the method used to determine the daily intakes is described elsewhere (34) . The nutrient and energy intakes (EI) were calculated by multiplying the daily intake of each food item by the nutrient and energy content (per 100 g), derived from the South African Food Composition Tables, and then adding the contribution from all food items together (35) .…”

Dietary Patterns and Breast Cancer Risk in Black Urban South African Women: The SABC Study

“…A validated and culture-specific quantified food frequency questionnaire (QFFQ) was used, together with food models, food portion pictures and household utensils alongside the South African Food Composition Tables to determine habitual dietary intake [21][22][23][24]. A detailed description of the QFFQ and method used to determine the daily intakes are described elsewhere [10]. The nutrient and energy intakes (EI) were calculated by multiplying the daily intake of each food item by the nutrient and energy content (per 100 g), derived from the South African Food Composition Tables, and then by adding the contribution from all food items together [24].…”

“…However, research on the association between diet and breast cancer risk in South Africa is limited. A previous study conducted in black women from Soweto, South Africa, showed that higher adherence to an adapted version of the 2018 World Cancer Research Fund/American Institute for Cancer Research's Cancer Prevention Recommendations was inversely associated with breast cancer risk [10]. Another study conducted on black women from Soweto, investigated the association between the degree of food processing and breast cancer risk.…”