Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/11099
Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study
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ISSN: 1741-7015
WOS ID: 000344889900001
Scopus EID: 2-s2.0-84907952984
PMID: 25319089
Embase PUI: L600155703
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Aleksandrova, Krasimira; Pischon, Tobias; Jenab, Mazda; Bueno-de-Mesquita, H. Bas; Fedirko, Veronika; Norat, Teresa; Romaguera, Dora

Publication date
2014-10-10Document type
research articleCitation
Aleksandrova K, Pischon T, Jenab M, Bueno-De-Mesquita HB, Fedirko V, Norat T, et al. Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study. BMC Med. 2014 Oct 10;12:168.Abstract
Background: Excess 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. Methods: In 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. Results: After 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. Conclusions: Combined 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.
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https://dx.doi.org/10.1186/s12916-014-0168-4Keywords
lifestyle factorscombined impact
population attributable risks
colorectal cancer
European Prospective Investigation into Cancer and Nutrition (EPIC)
MeSH
AgedEuropean Continental Ancestry Group
Alcohol Drinking
Adult
Humans
Life Style
Middle Aged
Diet
Health Behavior
Male
Prospective Studies
Europe
Female
Risk Factors
Colorectal Neoplasms
Proportional Hazards Models
Cohort Studies
Incidence
DeCS
Estudios de CohortesIncidencia
Modelos de Riesgos Proporcionales
Neoplasias Colorrectales
Femenino
Conductas Relacionadas con la Salud
Europa (Continente)
Dieta
Grupo de Ascendencia Continental Europea
Masculino
Factores de Riesgo
Humanos
Persona de Mediana Edad
Estudios Prospectivos
Estilo de Vida
Anciano
Adulto
Consumo de Bebidas Alcohólicas
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Hospital Universitario Son Espases - HUSE > Comunicación científicaInstituto de Investigación Sanitaria Islas Baleares - IDISBA > Comunicación científica