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Title: Healthy lifestyle and the risk of pancreatic cancer in the EPIC study
Author: Naudin, Sabine
Viallon, Vivian
Hashim, Dana
Freisling, Heinz
Jenab, Mazda
Weiderpass, Elisabete
Perrier, Flavie
Mckenzie, Fiona
Bueno de Mesquita, H. Bas
Olsen, Anja
Tjønneland, Anne
Dahm, Christina C.
Overvad, Kim
Mancini, Francesca Romana
Rebours, Vinciane
Boutron-Ruault, Marie-Christine
Katzke, Verena
Kaaks, Rudolf
Bergmann, Manuela M.
Boeing, Heiner
Peppa, Eleni
Karakatsani, Anna
Trichopoulou, Antonia
Pala, Valeria
Masala, Giovana
Panico, Salvatore
Tumino, Rosario
Sacerdote, Carlotta
May, Anne M.
van Gils, Carla H.
Rylander, Charlotta
Borch, Kristin Benjaminsen
Chirlaque, María Dolores
Sánchez, Maria Jose
Ardanaz, Eva
Quirós, J. Ramón
Amiano, Pilar
Sund, Malin
Drake, Isabel
Regnér, Sara
Travis, Ruth C.
Wareham, Nick
Aune, Dagfinn
Riboli, Elio
Gunter, Marc
Duell, Eric J.
Brennan, Paul
Ferrari, Pietro
Keywords: Càncer de pàncrees
Estils de vida
Pancreas cancer
Issue Date: 1-Oct-2020
Publisher: Springer
Abstract: 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 HLI(BMI)and HLI(WHR)were 0.84 (95% CI: 0.79, 0.89; p(trend) = 4.3e-09) and 0.77 (0.72, 0.82; p(trend) = 1.7e-15), respectively. Exclusions of smoking from HLI(WHR)resulted in HRs of 0.88 (0.82, 0.94; p(trend) = 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.
Note: Versió postprint del document publicat a:
It is part of: European Journal Oo Epidemiology, 2020, vol. 35, num. 10, p. 975-986
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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