Background
Methods
The UK Biobank Study
Ethics
Score to measure adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations
Assessment of outcomes
Covariates
Statistical analyses
Sensitivity analyses
Results
Participant characteristics
Low (0–3.5) | Middle (3.75–4.25) | High (4.5–7) | Overall (0–7) | |
---|---|---|---|---|
Total score (points) | 2.84 (0.60) | 4.00 (0.20) | 5.01 (0.48) | 3.84 (1.04) |
Number of participants, n (%) | 39,048 (41.2) | 25,923 (27.4) | 29,807 (31.5) | 94,778 (100) |
Sex, n (%) | ||||
Females | 16,476 (42.2) | 14,187 (54.7) | 19,965 (67.0) | 50,628 (53.4) |
Males | 22,572 (57.8) | 11,736 (45.3) | 9842 (33.0) | 44,150 (46.6) |
Age (years) | 55.7 (7.9) | 56.1 (7.9) | 55.8 (7.9) | 55.8 (7.9) |
Country of recruitment, n (%) | ||||
England | 35,648 (91.3) | 23,781 (91.8) | 27,348 (91.8) | 86,777 (91.6) |
Scotland | 2113 (5.4) | 1368 (5.3) | 1604 (5.4) | 5085 (5.4) |
Wales | 1287 (3.3) | 774 (3.0) | 855 (2.9) | 2916 (3.1) |
Education, n (%) | ||||
College or University degree | 16,959 (43.4) | 12,755 (49.2) | 16,092 (54.0) | 45,806 (48.3) |
A levels/AS levels or equivalent | 5430 (13.9) | 3590 (13.9) | 3806 (12.8) | 12,826 (13.53 |
O levels/GCSEs or equivalent | 8293 (21.2) | 4767 (18.4) | 5077 (17.0) | 18,137 (19.1) |
CSEs or equivalent | 1523 (3.9) | 824 (3.2) | 780 (2.6) | 3127 (3.3) |
NVQ or HND or HNC or equivalent | 2330 (6.0) | 1247 (4.8) | 1104 (3.7) | 4681 (4.9) |
Other professional qualifications | 1766 (4.5) | 1242 (4.8) | 1478 (5.0) | 4486 (4.7) |
None of the above | 2670 (6.8) | 1454 (5.6) | 1403 (4.7) | 5527 (5.8) |
Do not know/prefer not to answer | 77 (0.2) | 44 (0.2) | 67 (0.2) | 188 (0.2) |
Townsend deprivation index | − 1.66 (2.82) | − 1.77 (2.77) | − 1.61 (2.86) | − 1.67 (2.82) |
Ethnicity, n (%) | ||||
White | 38,044 (97.4) | 25,142 (97.0) | 28,543 (95.8) | 91,729 (96.8) |
Mixed and other | 373 (1.0) | 277 (1.1) | 422 (1.4) | 1072 (1.1) |
Asian or Asian British | 271 (0.7) | 262 (1.0) | 435 (1.5) | 968 (1.0) |
Black or Black British | 323 (0.8) | 182 (0.7) | 256 (0.9) | 761 (0.8) |
Chinese | 37 (0.1) | 60 (0.2) | 151 (0.5) | 248 (0.3) |
Smoking, n (%) | ||||
Never | 21,301 (54.6) | 15,286 (59.0) | 18,391 (61.7) | 54,978 (58.0) |
Former smoker | 14,363 (36.8) | 8961 (34.6) | 9945 (33.4) | 33,269 (35.1) |
Current smoker | 3318 (8.5) | 1642 (6.3) | 1429 (4.8) | 6389 (6.7) |
Unknown | 66 (0.2) | 34 (0.1) | 42 (0.1) | 142 (0.2) |
Adherence score and cancer incidence
Model 1 | Model 2 | |||||
---|---|---|---|---|---|---|
Cancer site | Total | Incident cancers | HR (95% CI) | P value | HR (95% CI) | P value |
All cancers combined | 93,630 | 7296 | 0.92 (0.90; 0.94) | < 0.001a | 0.93 (0.90; 0.95) | < 0.001a |
Prostate | 43,851 | 1818 | 1.01 (0.96; 1.05) | 0.759 | 1.00 (0.96; 1.05) | 0.959 |
Breast | 50,337 | 1438 | 0.90 (0.85; 0.95) | < 0.001a | 0.90 (0.86; 0.95) | < 0.001a |
Pre-menopausal | 1108 | 154 | 0.83 (0.72; 0.96) | 0.014 | 0.83 (0.72; 0.96) | 0.013 |
Post-menopausal | 49,229 | 1284 | 0.90 (0.85; 0.95) | < 0.001a | 0.90 (0.85; 0.95) | < 0.001a |
Colorectal | 94,656 | 863 | 0.89 (0.83; 0.95) | 0.001a | 0.90 (0.84; 0.97) | 0.003a |
Colon | 94,698 | 575 | 0.83 (0.76; 0.90) | < 0.001a | 0.83 (0.77; 0.90) | < 0.001a |
Distal | 94,734 | 242 | 0.74 (0.65; 0.84) | < 0.001a | 0.75 (0.66; 0.85) | < 0.001a |
Proximal | 94,748 | 303 | 0.89 (0.80; 1.00) | 0.050 | 0.90 (0.81; 1.01) | 0.074 |
Rectum | 94,734 | 342 | 1.00 (0.91; 1.12) | 0.878 | 1.03 (0.93; 1.15) | 0.588 |
Lung | 94,760 | 431 | 0.86 (0.78; 0.94) | < 0.001a | 0.93 (0.84; 1.02) | 0.125 |
Kidney | 94,754 | 221 | 0.82 (0.72; 0.93) | 0.003a | 0.82 (0.72; 0.94) | 0.004 |
Pancreas | 94,770 | 213 | 0.87 (0.76; 0.99) | 0.035 | 0.88 (0.77; 1.00) | 0.056 |
Uterus | 50,588 | 212 | 0.93 (0.81; 1.06) | 0.269 | 0.92 (0.81; 1.05) | 0.227 |
Oesophagus | 94,765 | 151 | 0.81 (0.69; 0.95) | 0.010 | 0.84 (0.71; 0.98) | 0.031 |
Ovary | 50,603 | 147 | 0.76 (0.65; 0.90) | 0.001a | 0.76 (0.65; 0.90) | 0.001a |
Bladder | 94, 756 | 141 | 0.88 (0.74; 1.03) | 0.116 | 0.90 (0.76; 1.07) | 0.240 |
Head and neck | 94,763 | 129 | 1.17 (0.99; 1.40) | 0.068 | 1.21 (1.02; 1.44) | 0.031 |
Stomach | 94,770 | 99 | 0.97 (0.79; 1.18) | 0.725 | 0.98 (0.80; 1.19) | 0.830 |
Liver | 94,773 | 82 | 0.77 (0.62; 0.96) | 0.017 | 0.78 (0.63; 0.97) | 0.024 |
Gallbladder | 94,777 | 49 | 0.71 (0.54; 0.94) | 0.017 | 0.70 (0.53; 0.93) | 0.013 |
Low score (0–3.5) | Mid score (3.75–4.25) | Higher score (4.5–7) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Model 1 | Model 2 | Model 1 | Model 2 | ||||||||
Cancer site | Total | Incident cancers | HR (95% CI) | HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value |
All cancers combined | 93,630 | 7296 | 1.00 (ref) | 0.91 (0.86; 0.97) | 0.001a | 0.92 (0.87; 0.97) | 0.004 | 0.83 (0.78; 0.87) | < 0.001a | 0.84 (0.79; 0.89) | < 0.001a |
Prostate | 43,851 | 1818 | 1.00 (ref) | 1.06 (0.95; 1.18) | 0.275 | 1.06 (0.95; 1.18) | 0.306 | 0.98 (0.87; 1.10) | 0.686 | 0.96 (0.85; 1.08) | 0.499 |
Breast | 50,337 | 1438 | 1.00 (ref) | 0.82 (0.72; 0.93) | 0.003 | 0.82 (0.72; 0.94) | 0.003 | 0.82 (0.73; 0.93) | 0.001a | 0.82 (0.73; 0.93) | 0.002a |
Pre-menopausal | 1108 | 154 | 1.00 (ref) | 0.58 (0.38; 0.89) | 0.013 | 0.58 (0.38; 0.89) | 0.013 | 0.67 (0.47; 0.97) | 0.032 | 0.67 (0.47; 0.96) | 0.031 |
Post-menopausal | 49,229 | 1284 | 1.00 (ref) | 0.83 (0.72; 0.96) | 0.010 | 0.83 (0.72; 0.96) | 0.011 | 0.81 (0.72; 0.93) | 0.002a | 0.82 (0.72; 0.93) | 0.002a |
Colorectal | 94,656 | 862 | 1.00 (ref) | 0.78 (0.66; 0.92) | 0.004 | 0.79 (0.67; 0.93) | 0.006 | 0.76 (0.65; 0.90) | 0.001a | 0.79 (0.66; 0.93) | 0.005 |
Colon | 94,698 | 575 | 1.00 (ref) | 0.69 (0.56; 0.85) | < 0.001a | 0.69 (0.57; 0.85) | 0.001a | 0.67 (0.55; 0.82) | < 0.001a | 0.69 (0.56; 0.84) | < 0.001a |
Distal | 94,734 | 242 | 1.00 (ref) | 0.62 (0.46; 0.86) | 0.003 | 0.62 (0.45; 0.85) | 0.003 | 0.54 (0.39; 0.76) | < 0.001a | 0.56 (0.40; 0.77) | < 0.001a |
Proximal | 94,748 | 303 | 1.00 (ref) | 0.77 (0.58; 1.02) | 0.069 | 0.78 (0.59; 1.03) | 0.084 | 0.75 (0.57; 1.00) | 0.057 | 0.77 (0.58; 1.02) | 0.067 |
Rectum | 94,734 | 342 | 1.00 (ref) | 0.97 (0.74; 1.25) | 0.789 | 0.99 (0.76; 1.28) | 0.943 | 0.97 (0.74; 1.26) | 0.798 | 1.01 (0.78; 1.32) | 0.926 |
Lung | 94,760 | 431 | 1.00 (ref) | 0.92 (0.73; 1.15) | 0.465 | 1.02 (0.81; 1.27) | 0.895 | 0.67 (0.52; 0.85) | 0.001a | 0.80 (0.63; 1.02) | 0.073 |
Kidney | 94,754 | 221 | 1.00 (ref) | 0.85 (0.62; 1.16) | 0.299 | 0.85 (0.62; 1.17) | 0.322 | 0.64 (0.45; 0.90) | 0.011 | 0.64 (0.45; 0.92) | 0.014 |
Pancreas | 94,770 | 213 | 1.00 (ref) | 0.72 (0.52; 1.01) | 0.061 | 0.74 (0.53; 1.04) | 0.076 | 0.73 (0.52; 1.01) | 0.058 | 0.75 (0.53; 1.04) | 0.087 |
Uterus | 50,588 | 212 | 1.00 (ref) | 1.00 (0.71; 1.40) | 0.994 | 0.99 (0.71; 1.39) | 0.964 | 0.84 (0.61; 1.16) | 0.287 | 0.83 (0.60; 1.14) | 0.250 |
Oesophagus | 94,765 | 151 | 1.00 (ref) | 0.89 (0.61; 1.29) | 0.534 | 0.92 (0.63; 1.34) | 0.665 | 0.60 (0.39; 0.92) | 0.020 | 0.64 (0.41; 0.99) | 0.046 |
Ovary | 50,603 | 147 | 1.00 (ref) | 0.69 (0.46; 1.03) | 0.071 | 0.69 (0.46; 1.03) | 0.070 | 0.57 (0.39; 0.84) | 0.005 | 0.57 (0.39; 0.84) | 0.005 |
Bladder | 94,756 | 141 | 1.00 (ref) | 0.70 (0.47; 1.06) | 0.093 | 0.73 (0.48; 1.10) | 0.135 | 0.67 (0.43; 1.03) | 0.066 | 0.72 (0.47; 1.11) | 0.137 |
Head and Neck | 94,763 | 129 | 1.00 (ref) | 1.45 (0.95; 2.22) | 0.086 | 1.51 (0.98; 2.31) | 0.060 | 1.42 (0.93; 2.18) | 0.108 | 1.52 (0.99; 2.33) | 0.057 |
Stomach | 94,770 | 99 | 1.00 (ref) | 1.01 (0.63; 1.62) | 0.982 | 1.02 (0.64; 1.65) | 0.920 | 0.94 (0.57; 1.54) | 0.804 | 0.97 (0.59; 1.59) | 0.899 |
Liver | 94,773 | 82 | 1.00 (ref) | 0.78 (0.46; 1.33) | 0.364 | 0.80 (0.47; 1.35) | 0.397 | 0.66 (0.38; 1.15) | 0.142 | 0.68 (0.39; 1.18) | 0.172 |
Gallbladder | 94,777 | 49 | 1.00 (ref) | 0.68 (0.34; 1.35) | 0.269 | 0.67 (0.34; 1.33) | 0.251 | 0.56 (0.27; 1.15) | 0.115 | 0.54 (0.26; 1.12) | 0.098 |