Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/126295
Title: Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study
Author: Aleksandrova, Krasimira
Pischon, Tobias
Jenab, Mazda
Bueno de Mesquita, H. Bas
Fedirko, Veronika
Norat, Teresa
Romaguera, Dora
Knuppel, Sven
Boutron-Ruault, Marie-Christine
Dossus, Laure
Dartois, Laureen
Kaaks, Rudolf
Li, Kuanrong
Tjønneland, Anne
Overvad, Kim
Quirós, J. Ramón
Buckland, Genevieve
Sánchez, María José
Dorronsoro, Miren
Chirlaque, María Dolores
Barricarte, Aurelio
Khaw, Kay-Tee
Wareham, Nicholas J.
Bradbury, Kathryn E.
Trichopoulou, Antonia
Lagiou, Pagona
Trichopoulos, Dimitrios
Palli, Domenico
Krogh, Vittorio
Tumino, Rosario
Naccarati, Alessio
Panico, Salvatore
Siersema, Peter D.
Peeters, Petra H. M.
Ljuslinder, Ingrid
Johansson, Ingegerd
Ericson, Ulrika
Ohlsson, Bodil
Weiderpass, Elisabete
Skeie, Guri
Benjaminsen Borch, Kristin
Rinaldi, Sabina
Romieu, Isabelle
Kong, Joyce
Gunter, Marc
Ward, Heather A.
Riboli, Elio
Boeing, Heiner
Keywords: Càncer colorectal
Estils de vida
Colorectal cancer
Lifestyles
Issue Date: 10-Oct-2014
Publisher: BioMed Central Ltd
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.
Note: Reproducció del document publicat a: https://doi.org/10.1186/s12916-014-0168-4
It is part of: BMC Medicine, 2014, vol. 12, num. 168
URI: http://hdl.handle.net/2445/126295
Related resource: https://doi.org/10.1186/s12916-014-0168-4
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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