RT Journal Article
T1 Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study.
A1 Aleksandrova, Krasimira
A1 Pischon, Tobias
A1 Jenab, Mazda
A1 Bueno-de-Mesquita, H
A1 Fedirko, Veronika
A1 Norat, Teresa
A1 Romaguera, Dora
A1 Knüppel, Sven
A1 Boutron-Ruault, Marie-Christine
A1 Dossus, Laure
A1 Dartois, Laureen
A1 Kaaks, Rudolf
A1 Li, Kuanrong
A1 Tjønneland, Anne
A1 Overvad, Kim
A1 Quirós, José Ramón
A1 Buckland, Genevieve
A1 Sanchez-Perez, Maria-Jose
A1 Dorronsoro, Miren
A1 Chirlaque, Maria-Dolores
A1 Barricarte, Aurelio
A1 Khaw, Kay-Tee
A1 Wareham, Nicholas J
A1 Bradbury, Kathryn E
A1 Trichopoulou, Antonia
A1 Lagiou, Pagona
A1 Trichopoulos, Dimitrios
A1 Palli, Domenico
A1 Krogh, Vittorio
A1 Tumino, Rosario
A1 Naccarati, Alessio
A1 Panico, Salvatore
A1 Siersema, Peter D
A1 Peeters, Petra
A1 Ljuslinder, Ingrid
A1 Johansson, Ingegerd
A1 Ericson, Ulrika
A1 Ohlsson, Bodil
A1 Weiderpass, Elisabete
A1 Skeie, Guri
A1 Borch, Kristin
A1 Rinaldi, Sabina
A1 Romieu, Isabelle
A1 Kong, Joyce
A1 Gunter, Marc J
A1 Ward, Heather A
A1 Riboli, Elio
A1 Boeing, Heiner
K1 Lifestyle factors
K1 Combined impact
K1 Population attributable risks
K1 Colorectal cancer
K1 European Prospective Investigation into Cancer and Nutrition (EPIC)
K1 Neoplasias colorrectales
K1 Consumo de alcohol
K1 Dieta
K1 Hábito de fumar
AB BACKGROUNDExcess body weight, physical activity, smoking, alcohol consumption and certain dietary factors are individually related to colorectal cancer (CRC) risk; however, little is known about their joint effects. The aim of this study was to develop a healthy lifestyle index (HLI) composed of five potentially modifiable lifestyle factors - healthy weight, physical activity, non-smoking, limited alcohol consumption and a healthy diet, and to explore the association of this index with CRC incidence using data collected within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.METHODSIn the EPIC cohort, a total of 347,237 men and women, 25- to 70-years old, provided dietary and lifestyle information at study baseline (1992 to 2000). Over a median follow-up time of 12 years, 3,759 incident CRC cases were identified. The association between a HLI and CRC risk was evaluated using Cox proportional hazards regression models and population attributable risks (PARs) have been calculated.RESULTSAfter accounting for study centre, age, sex and education, compared with 0 or 1 healthy lifestyle factors, the hazard ratio (HR) for CRC was 0.87 (95% confidence interval (CI): 0.44 to 0.77) for two factors, 0.79 (95% CI: 0.70 to 0.89) for three factors, 0.66 (95% CI: 0.58 to 0.75) for four factors and 0.63 (95% CI: 0.54 to 0.74) for five factors; P-trend <0.0001. The associations were present for both colon and rectal cancers, HRs, 0.61 (95% CI: 0.50 to 0.74; P for trend <0.0001) for colon cancer and 0.68 (95% CI: 0.53 to 0.88; P-trend <0.0001) for rectal cancer, respectively (P-difference by cancer sub-site = 0.10). Overall, 16% of the new CRC cases (22% in men and 11% in women) were attributable to not adhering to a combination of all five healthy lifestyle behaviours included in the index.CONCLUSIONSCombined lifestyle factors are associated with a lower incidence of CRC in European populations characterized by western lifestyles. Prevention strategies considering complex targeting of multiple lifestyle factors may provide practical means for improved CRC prevention.
PB BioMed Central
YR 2014
FD 2014-10-10
LK http://hdl.handle.net/10668/1988
UL http://hdl.handle.net/10668/1988
LA en
NO Aleksandrova K, Pischon T, Jenab M, Bueno-de-Mesquita H, Fedirko V, Norat T, et al. Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study. BMC Med. 2014; 12(1): 168
NO JOURNAL ARTICLE;
DS RISalud
RD Apr 10, 2025