Better lifestyle choices may prevent cancer in adults with prediabetes, T2D

Alignment with the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations, which involve modifying certain lifestyle factors, appears to reduce the risk of cancer development in adults with prediabetes or type 2 diabetes (T2D), reports a recent study.

The authors randomized participants to lifestyle, metformin, or placebo intervention (mean 3 years) and followed them for an additional 19 years. They calculated the 2018 WCFR/AICR score (0–7 points; higher score, better alignment) from body weight, physical activity, diet, and alcohol components at 0, 1, 5, 6, 9, and 15 years after randomization.

Incident cancer was based on the 2018 WCFR/AICR 3rd Expert Report (18 cancer associated with lifestyle). The associations between the score (baseline [0], change from 0 to 1 years, time-dependent) and lifestyle-related cancer were estimated using adjusted Cox proportional hazard models. 

A total of 3,000 participants were included in the analysis. They had a mean baseline WCFR/AICR score of 3.2. Some 403 incident lifestyle-related cancer cases were recorded.

WCFR/AICR scores improved after 1 and 15 years (mean increase 0.43 and 0.27 points, respectively; p<0.001 for both). 

The baseline score showed no significant association with cancer risk. However, a 1-unit score improvement from 0 to 1 year and time-dependent scores significantly correlated with a 14-percent (hazard ratio [HR], 0.86, 95 percent confidence interval [CI], 0.76–0.97) and 9-percent (HR, 0.91, 95 percent CI, 0.83–0.997) reduction in cancer risk, respectively. No effect modification by intervention group or diabetes status was noted.

Exploratory by-component analyses revealed no significant association between any single component and cancer risk.

“Modifying lifestyle factors may reduce the incidence of obesity, diabetes, and cancer,” the authors said.