Table 3.

The associations between ACS Guidelines on Nutrition and Physical Activity for Cancer Prevention compliance score and cancer incidence by baseline health and smoking status

Total analytic populationParticipants without chronic disease at baseline
ACS ScoreAll incident cancersAll incident cancersIncident cancers excluding lung cancer
(# Guidelines met)CohortCasesHR (95%CI)aCohortCasesHR (95%CI)aCasesHR (95%CI)a
04,4271511 (Ref.)1,949671 (Ref.)551 (Ref.)
128,0591,0471.05 (0.88–1.24)10,2813460.93 (0.71–1.21)2740.85 (0.64–1.15)
221,2188031.01 (0.84–1.20)9,1522920.85 (0.65–1.12)2380.79 (0.58–1.06)
36,4042070.88 (0.71–1.09)3,423910.70 (0.51–0.97)720.60 (0.42–0.87)
4990320.96 (0.65–1.42)704140.55 (0.31–0.99)110.44 (0.23–0.86)
Ptrend0.090.0030.001
Current smokers
02,9261141 (Ref.)1,353521 (Ref.)401 (Ref.)
111,7175181.00 (0.82–1.23)5,1442020.95 (0.70–1.29)1390.86 (0.61–1.23)
28,4123500.94 (0.75–1.16)4,4551510.83 (0.60–1.14)1080.77 (0.53–1.11)
32,286870.84 (0.63–1.11)1,351400.69 (0.46–1.06)280.61 (0.38–1.00)
4288161.40 (0.83–2.38)20260.73 (0.31–1.71)40.60 (0.21–1.68)
Ptrend0.310.030.03
Never and former smokers
01,501371 (Ref.)596151 (Ref.)151 (Ref.)
116,3425291.18 (0.84–1.65)51371440.96 (0.56–1.65)1350.88 (0.51–1.52)
212,8064531.16 (0.83–1.64)46971410.93 (0.54–1.61)1300.84 (0.49–1.45)
34,1181200.98 (0.67–1.42)2072510.73 (0.40–1.32)440.60 (0.33–1.10)
4702160.80 (0.44–1.45)50280.47 (0.19–1.12)70.38 (0.15–0.96)
Ptrend0.160.030.007
  • NOTE: The ACS score was created by counting and summing (0–4) the number of ACS Guidelines on Nutrition and Physical Activity for Cancer Prevention the participant met upon entry into the cohort (assigning one point for each of: 18.5 ≤ BMI < 25 kg/m2, meeting physical activity guidelines, meeting ≥2 sub-guidelines for the ACS diet quality score, and being a non or moderate alcohol drinker). Participants without chronic disease at baseline include participants without a diagnosis of diabetes, hypertension, or chronic obstructive pulmonary disease.

  • Abbreviations: ACS, American Cancer Society; CI, confidence interval; Ref, reference.

  • aAdjusted for sex, race, enrollment source, family history of cancer, insurance coverage, education, income, marital status, neighborhood deprivation index, smoking status, total energy intake, and postmenopausal hormone use (women only).