ADHERENCE TO THE EUROPEAN CODE AGAINST CANCER IN RELATION TO LONG-TERM CANCER MORTALITY - INTERCOHORT COMPARISONS FROM THE 7 COUNTRIES STUDY

Within the Seven Countries Study, we investigated whether population d ifferences in 25-year cancer mortality and mortality due to cancer of the lung, stomach, and colorectum could be explained by population dif ferences in adherence to the European Code Against Cancer, Baseline su rveys were carried out around 1960 on 12,763 middle-aged men constitut ing 16 cohorts in seven countries; small samples of the cohorts kept d ietary records. In 1987, food equivalent composites representing the a verage food intake of each cohort at baseline were collected locally a nd analyzed in one central laboratory. The vital status of all partici pants was verified after 25 years of follow-up. Overall adherence to t he first four recommendations of the European Code Against Cancer was inversely related to 25-year total cancer mortality but not to all-cau se mortality. The association with cancer mortality was essentially du e to the inverse association for adherence to the guideline on smoking only. Each decrease in the percentage of smokers of 3.4% (10% of rang e) was associated with a relative risk of 0.93 of dying from cancer. A dherence to the recommendation on consumption of vegetables, fruits an d fiber-rich cereals was inversely related to stomach cancer mortality , whereas adherence to the recommendation on body weight physical acti vity, and intake of fat was associated with higher stomach cancer mort ality.