Adherence to the World Cancer Research Fund/American Institute for Cancer Research Guideline Is Associated With Better Health-Related Quality of Life Among Chinese Patients With Breast Cancer

Abstract

The 2007 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guideline provides recommendations for cancer prevention among cancer survivors. Limited data have examined whether guideline adherence is related to health-related quality of life (HRQoL) among Chinese patients with breast cancer. An ongoing prospective cohort study involving 1,462 Chinese women with early-stage breast cancer assessed exercise, diet, and body mass index (BMI) at baseline and at 18-months follow-up after diagnosis. Each assessment recorded patient habits within the previous 12 months. HRQoL was evaluated by the EORTC Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). We first compared the level of adherence to WCRF/AICR recommendations before and after cancer diagnosis. We then examined whether adherence to these recommendations after diagnosis was associated with HRQoL at 18 months. The mean adherence score significantly increased from baseline (3.2; SD, 1.1) to 18-month follow-up (3.9; SD, 1.1; <.001). Overall, increasing adherence to the WCRF/AICR guideline was associated with higher scores of global health status/quality of life (QoL; =.011), physical (<.001) and role functioning (=.024), and lower scores for fatigue (=.016), nausea and vomiting (<.001), pain (=.004), dyspnea (=.030), loss of appetite (=.007), and diarrhea (=.020). Patients with cancer who met the BMI recommendation had higher scores for physical functioning (=.001) and lower scores for fatigue (=.024), pain (<.001), and dyspnea (=.045). Adherence to physical activity recommendation was associated with better scores of global health status/QoL (<.001), physical functioning (=.003), fatigue (=.002), pain (=.018), and dyspnea (=.021). Higher adherence to diet recommendation was associated with lower scores of nausea and vomiting (=.005), loss of appetite (=.026), constipation (=.040), and diarrhea (=.031). Chinese patients with breast cancer made positive lifestyle changes early after cancer diagnosis. Increased adherence to WCRF/AICR recommendations after cancer diagnosis may improve HRQoL. Our data suggest that Chinese patients with breast cancer should follow the WCRF/AICR guideline to improve overall well-being.

Adherence to the American Cancer Society Guidelines for Cancer Survivors and Health-Related Quality of Life among Breast Cancer Survivors

“…The findings of the present study are consistent with our previous research and other observational studies [3][4][5]23,24,26,35,36]. We found that Korean breast cancer survivors with greater adherence to the ACS guidelines had higher levels of social functioning, which was assessed by a validated Korean version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) [24].…”

“…In another cross-sectional study that we conducted, two dietary patterns, the healthy dietary pattern and the Western dietary pattern, were empirically derived using factor analysis among Korean breast cancer survivors, and higher healthy dietary pattern scores were associated with decreasing dyspnea and increasing insomnia scores [35]. A prospective cohort study in Hong Kong involving 1,462 Chinese breast cancer survivors investigated the association between adherence to the WCRF/AICR guidelines and HRQoL and showed that greater adherence to cancer prevention recommendations was related to higher scores for global health status, physical functioning, and role functioning, and lower scores for fatigue and pain [23]. Among elderly female breast cancer survivors in the Iowa Women's Health Study, the participants who adhered to the WCRF/AICR diet and physical activity guidelines had better physical and mental component summary scores compared to those who did not follow the guidelines [26].…”

Behavioral health risk factor profiles in general hospital patients: identifying the need for screening and brief intervention

“…HRFs inhibit successful recovery or improved wellbeing and increase mortality after diagnosis as found for cancer patients (e.g. [4,5]). To prevent and treat prevalent non-communicable diseases, abstaining from tobacco smoking, keeping body weight within the healthy range, being physically active as part of everyday life, and limiting alcohol consumption is recommended [2,[6][7][8].…”

Alcohol abuse and oncology

“…The American Cancer Society's nutrition and lifestyle recommendations include, in addition to physical activity and predominantly plant-based diet, alcohol reduction or abstinence. These recommendations are also useful in the prevention of other diseases and improve the lives of cancer patients (Lei et al, 2018).…”