Adherence to the 2018 WCRF/AICR cancer prevention guidelines and chronic lymphocytic leukemia in the MCC-Spain study

Cancer Epidemiol. 2020 Feb:64:101629. doi: 10.1016/j.canep.2019.101629. Epub 2019 Nov 19.


Introduction: Preventable risk factors for chronic lymphocytic leukemia (CLL) remain largely unknown. The aim of this study was to evaluate the association between adherence to nutrition-based guidelines for cancer prevention and CLL, in the MCC-Spain case-control study.

Methods: A total of 318 CLL cases and 1293 population-based controls were included in the present study. The World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) score based on the 2018 recommendations for cancer prevention (on body fatness, physical activity, and diet) was constructed. We used logistic regression analysis adjusting for potential confounders.

Results: Individuals in the highest tertile of the WCRF/AICR score had an odds ratio for CLL of 1.25 (95 % CI 0.91; 1.73) compared with individuals with low adherence (p-trend = 0.172). Each point increment in the score was associated with an OR for CLL of 1.06 (95 % CI 0.91; 1.23). Analyses by severity of disease did not show significant heterogeneity of effects.

Conclusion: Overall, our results do not support an association between the WCRF/AICR score and CLL, yet we might have been limited by statistical power and study design to detect modest associations. Further research, ideally with a prospective design, long follow-up, and including additional lymphoma subtypes, is warranted to confirm the impact of composite healthy lifestyle behaviors on lymphoma risk.

Keywords: Case-control study; Chronic lymphocytic leukemia; Nutrition-based guidelines; WCRF/AICR 2018 recommendations.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Composition
  • Case-Control Studies
  • Diet / statistics & numerical data
  • Exercise
  • Female
  • Guideline Adherence / statistics & numerical data
  • Health Behavior
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / epidemiology*
  • Leukemia, Lymphocytic, Chronic, B-Cell / prevention & control*
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Prospective Studies
  • Risk Factors
  • Spain / epidemiology
  • Young Adult