2026/06/11 by Mar Nafría, Evertine Wesselink, Ellen Kampman +5
Medicine · #Cancer survivorship and care #Global Cancer Incidence and Screening #Nutritional Studies and Diet
paper · doi:10.1158/1055-9965.epi-25-2056
openalex publication_date 2026/06/11 · openalex created_date 2026/06/12 · openalex updated_date 2026/07/03
BACKGROUND: To enable fast and individual assessment of adherence to World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations, the WCRF/AICR Screener was developed and validated. While the recommendations are grounded in strong epidemiological evidence, this study evaluated the external applicability of the Screener, including its association with all-cause mortality, variable contribution, and prognostic performance compared with the standard 2018 WCRF/AICR Score. METHODS: We analyzed 1919 newly diagnosed stage I-IV colorectal cancer (CRC) patients from the prospective Dutch COLON study. Adherence to the recommendations was assessed at diagnosis using the algorithm from the Screener and, for comparison, the Score. Primary outcome was all-cause mortality. Cox proportional hazards models estimated HRs and 95% CIs for mortality per 1-SD increase and across quartiles. Models were adjusted for potential confounders. Leave-one-out analysis evaluated individual variable contribution. RESULTS: 533 deaths occurred during a median follow-up of 8.3 years. Greater adherence (highest vs. lowest quartile) to the Screener was associated to lower all-cause mortality (HR: 0.73, 95% CI: 0.57-0.93). Comparable associations were observed for the Score (HR: 0.82, 95% CI: 0.64-1.05). CONCLUSIONS: The Screener showed comparable performance and external applicability to the Score in relation to all-cause mortality among CRC patients. IMPACT: The Screener may facilitate brief and practical lifestyle assessment in clinical and research settings, supporting risk stratification and integration of lifestyle evaluation into survivorship care.