The American Cancer Society (ACS) has guidelines on nutrition and physical activity for cancer survivors that focus on healthy body weight, physical activity, and a diet high in vegetables, fruits, and whole grains. To assess how adherence to those guidelines impacts disease-free survival (DFS), relapse-free survival (RFS), or overall survival (OS), researchers conducted a prospective study of 992 patients with stage III colon cancer who enrolled in an adjuvant chemotherapy clinical trial between 1991 and 2001. The researchers presented the study at the ASCO Annual Meeting.
They used a scoring system (score range = 0–6) to quantify adherence to the ACS guidelines based on body mass index, physical activity, and intake of vegetables, fruits, whole grains, and red or processed meats. The researchers also tested the score with and without alcohol since alcohol is included in the ACS guidelines for cancer prevention, but not for survivors.
At seven years of follow-up, 335 disease recurrences and 299 deaths (43 of which occurred without disease recurrence) were observed. For patients with lower scores (0–1), 26% (n = 262) had a trend toward improved DFS compared to 9% of patients with higher scores (5–6; n = 91; hazard ratio [HR] = 0.69; 95% CI = 0.45–1.06; p = 0.03), leading to a 42% lower risk of death for patients with lower scores (HR = 0.58; 95% CI = 0.34–0.99; p = 0.01).
When alcohol use was included in the score, the adjusted HRs for patients scores ranging from 6–8 points (n = 162; 16%) to 0–2 points (n = 187; 91%) were 0.49 for OS (95% CI = 0.32–0.76; p = 0.002), 0.58 for DFS (95% CI = 0.40–0.84; p = 0.01), and 0.64 for RFS (95% CI = 0.44–0.94; p = 0.05).
“Patients with colon cancer with a healthy body weight who engaged in physical activity, ate a diet high in whole grains, vegetables, and fruits and low in red/processed meats, and drank moderate alcohol had longer DFS and OS than patients who did not engage in these behaviors,” the authors concluded.