Does following WCRF’s Cancer Prevention Recommendations work?

Investigating adherence to the WCRF/AICR Cancer Prevention Recommendations and Cancer Risk and Survival in the UK

  • Topic: Combination of cancers
  • Institution: University of Newcastle
  • Country: United Kingdom
  • Status: Ongoing
Researcher: John Mathers
  • Grant awarded: November 2020

The WCRF’s Cancer Prevention Recommendations are a major step towards reducing cancer risk by improving lifestyle. However, it is still not clear how best to measure adherence to those Recommendations or the extent to which better adherence lowers cancer risk and improves survival after cancer diagnosis. In this project, we will address these issues using data for about half a million people who are participants in UK Biobank. My colleagues and I are delighted to receive support in this work from the WCRF via the Wereld Kanker Onderzoek Fonds. We hope that our findings will help to guide lifestyle recommendations and public health policies for the general population, and to improve length and quality of life for cancer survivors.

– John Mathers


Prof Mathers will investigate whether the more closely you follow WCRF’s Cancer Prevention Recommendations the lower your risk of cancer, and higher the chance of surviving after a cancer diagnosis.


In the UK, more than 1,000 new cancers are diagnosed each day and cancer accounts for over a quarter of all deaths. Lifestyle factors including body fatness, diet and exercise affect one’s risk of getting cancer and may also be linked to chances of surviving after cancer diagnosis. Approximately 40% of cancers in the UK could be prevented if everyone adopted a healthy lifestyle. In 2007, the World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) published 10 lifestyle-based Cancer Prevention Recommendations including maintaining a healthy body weight and eating little red and processed meat.

Studies have found that following to these recommendations leads to a reduced risk of cancer and reduced deaths from cancer. In 2018, these recommendations were updated and, in 2019, a scoring system from 1–10 was developed which determines how closely individuals adhere to these lifestyle targets.

How well the ‘adherence score’ works to predict cancer risk and survival have not yet been investigated, but the WCRF encouraged researchers worldwide to apply this ‘adherence score’ across different populations to test it. Furthermore, the adherence score has several potential limitations that may require refinement to optimise its predictive ability overall or for specific cancers.

Aims and objectives

The aim of this study is to investigate whether the adherence score predicts:

  • risk of developing cancer in the UK, and
  • survival after a cancer diagnosis in the UK.

We also aim to explore how important each recommendation is to the total adherence score, whether we can improve this score, and whether the score should be tailored for specific cancers.

How it will be done

In the first study of its kind, we will use data from the UK Biobank Study, which recruited over half a million men and women aged between 37 and 73 years across the UK between 2006 and 2010. This data includes detailed information about the participants, including diet, body fatness, and physical activity. Cancers that have occurred in people who took part in the UK Biobank study have already been identified and these statistics are updated periodically.

We will use these lifestyle data to calculate an adherence score for UK Biobank participants, and explore, using statistical techniques, whether this predicts the risk of developing cancer or the chance of surviving cancer in those diagnosed with it. We will also explore whether adding further recommendations, such as time spent sitting, affects these relationships.

Potential impact

The findings from this study could help to guide lifestyle recommendations and public health policies for the general population, and for cancer survivors, to reduce the risk of cancer and improve length, and quality of life. Refinements to the scoring system could provide a more accurate tool to assess adherence to the WCRF/AICR Cancer Prevention Recommendations in future studies worldwide.

Grant publication

Malcomson, F.C., Parra-Soto, S., Lu, L. et al. Operationalisation of a standardised scoring system to assess adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations in the UK biobank. Frontiers in Nutrition (2023)