RT Journal Article
T1 Healthy lifestyle and the risk of pancreatic cancer in the EPIC study.
A1 Naudin, Sabine
A1 Viallon, Vivian
A1 Hashim, Dana
A1 Freisling, Heinz
A1 Jenab, Mazda
A1 Weiderpass, Elisabete
A1 Perrier, Flavie
A1 McKenzie, Fiona
A1 Bueno-de-Mesquita, H Bas
A1 Olsen, Anja
A1 Tjønneland, Anne
A1 Dahm, Christina C
A1 Overvad, Kim
A1 Mancini, Francesca R
A1 Rebours, Vinciane
A1 Boutron-Ruault, Marie-Christine
A1 Katzke, Verena
A1 Kaaks, Rudolf
A1 Bergmann, Manuela
A1 Boeing, Heiner
A1 Peppa, Eleni
A1 Karakatsani, Anna
A1 Trichopoulou, Antonia
A1 Pala, Valeria
A1 Masala, Giovana
A1 Panico, Salvatore
A1 Tumino, Rosario
A1 Sacerdote, Carlotta
A1 May, Anne M
A1 van Gils, Carla H
A1 Rylander, Charlotta
A1 Borch, Kristin Benjaminsen
A1 Chirlaque López, María Dolores
A1 Sanchez-Perez, Maria-Jose
A1 Ardanaz, Eva
A1 Quirós, José Ramón
A1 Amiano Exezarreta, Pilar
A1 Sund, Malin
A1 Drake, Isabel
A1 Regnér, Sara
A1 Travis, Ruth C
A1 Wareham, Nick
A1 Aune, Dagfinn
A1 Riboli, Elio
A1 Gunter, Marc J
A1 Duell, Eric J
A1 Brennan, Paul
A1 Ferrari, Pietro
K1 EPIC
K1 Healthy Lifestyle Index
K1 Pancreatic cancer
K1 Population attributable fraction
K1 Prospective study
AB Pancreatic cancer (PC) is a highly fatal cancer with currently limited opportunities for early detection and effective treatment. Modifiable factors may offer pathways for primary prevention. In this study, the association between the Healthy Lifestyle Index (HLI) and PC risk was examined. Within the European Prospective Investigation into Cancer and Nutrition cohort, 1113 incident PC (57% women) were diagnosed from 400,577 participants followed-up for 15 years (median). HLI scores combined smoking, alcohol intake, dietary exposure, physical activity and, in turn, overall and central adiposity using BMI (HLIBMI) and waist-to-hip ratio (WHR, HLIWHR), respectively. High values of HLI indicate adherence to healthy behaviors. Cox proportional hazard models with age as primary time variable were used to estimate PC hazard ratios (HR) and 95% confidence intervals (CI). Sensitivity analyses were performed by excluding, in turn, each factor from the HLI score. Population attributable fractions (PAF) were estimated assuming participants' shift to healthier lifestyles. The HRs for a one-standard deviation increment of HLIBMI and HLIWHR were 0.84 (95% CI: 0.79, 0.89; ptrend = 4.3e-09) and 0.77 (0.72, 0.82; ptrend = 1.7e-15), respectively. Exclusions of smoking from HLIWHR resulted in HRs of 0.88 (0.82, 0.94; ptrend = 4.9e-04). The overall PAF estimate was 19% (95% CI: 11%, 26%), and 14% (6%, 21%) when smoking was removed from the score. Adherence to a healthy lifestyle was inversely associated with PC risk, beyond the beneficial role of smoking avoidance. Public health measures targeting compliance with healthy lifestyles may have an impact on PC incidence.
YR 2019
FD 2019-09-28
LK http://hdl.handle.net/10668/14564
UL http://hdl.handle.net/10668/14564
LA en
DS RISalud
RD Apr 6, 2025