Background: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body
fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for
cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations
measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality.
The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR
recommendations and mortality in colorectal cancer (CRC) patients.
Methods: The association between the WCRF/AICR score (score range 0–6 in men and 0–7 in women; higher
scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872)
and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in
the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after
diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs)
and 95% confidence intervals (CIs) for mortality.