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Combined impact of ...
Combined impact of healthy lifestyle factors on colorectal cancer : a large European cohort study
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Aleksandrova, Krasimira (author)
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Pischon, Tobias (author)
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Jenab, Mazda (author)
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Bueno-de-Mesquita, H Bas (author)
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Fedirko, Veronika (author)
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Norat, Teresa (author)
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Romaguera, Dora (author)
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Knüppel, Sven (author)
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Boutron-Ruault, Marie-Christine (author)
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Dossus, Laure (author)
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Dartois, Laureen (author)
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Kaaks, Rudolf (author)
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Li, Kuanrong (author)
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Tjønneland, Anne (author)
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Overvad, Kim (author)
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Quirós, José Ramón (author)
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Buckland, Genevieve (author)
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Sánchez, María José (author)
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Dorronsoro, Miren (author)
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Chirlaque, Maria-Dolores (author)
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Barricarte, Aurelio (author)
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Khaw, Kay-Tee (author)
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Wareham, Nicholas J (author)
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Bradbury, Kathryn E (author)
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Trichopoulou, Antonia (author)
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Lagiou, Pagona (author)
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Trichopoulos, Dimitrios (author)
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Palli, Domenico (author)
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Krogh, Vittorio (author)
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Tumino, Rosario (author)
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Naccarati, Alessio (author)
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Panico, Salvatore (author)
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Siersema, Peter D (author)
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Peeters, Petra HM (author)
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- Ljuslinder, Ingrid (author)
- Umeå universitet,Onkologi
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- Johansson, Ingegerd (author)
- Umeå universitet,Institutionen för odontologi
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- Ericson, Ulrika (author)
- Lund University,Lunds universitet,Diabetes - kardiovaskulär sjukdom,Forskargrupper vid Lunds universitet,Diabetes - Cardiovascular Disease,Lund University Research Groups
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- Ohlsson, Bodil (author)
- Lund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups
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- Weiderpass, Elisabete (author)
- Karolinska Institutet
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Skeie, Guri (author)
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Borch, Kristin (author)
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Rinaldi, Sabina (author)
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Romieu, Isabelle (author)
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Kong, Joyce (author)
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Gunter, Marc J (author)
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Ward, Heather A (author)
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Riboli, Elio (author)
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Boeing, Heiner (author)
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(creator_code:org_t)
- 2014-10-10
- 2014
- English.
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In: BMC Medicine. - : BioMed Central. - 1741-7015. ; 12:1, s. 168-
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https://bmcmedicine....
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http://dx.doi.org/10... (free)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Keyword
- acrylamide
- dietary questionnaires
- haemoglobin adducts
- biomarkers
- smoking
- measurement errors
- lifestyle factors
- combined impact
- population attributable risks
- colorectal cancer
- European Prospective Investigation into Cancer and Nutrition (EPIC)
- lifestyle factors
- combined impact
- population attributable risks
- colorectal cancer
- European Prospective Investigation into Cancer and
- Nutrition (EPIC)
Publication and Content Type
- ref (subject category)
- art (subject category)
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Aleksandrova, Kr ...
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Pischon, Tobias
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Jenab, Mazda
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Bueno-de-Mesquit ...
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Fedirko, Veronik ...
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Norat, Teresa
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show more...
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Romaguera, Dora
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Knüppel, Sven
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Boutron-Ruault, ...
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Dossus, Laure
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Dartois, Laureen
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Kaaks, Rudolf
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Li, Kuanrong
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Tjønneland, Anne
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Overvad, Kim
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Quirós, José Ram ...
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Buckland, Genevi ...
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Sánchez, María J ...
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Dorronsoro, Mire ...
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Chirlaque, Maria ...
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Barricarte, Aure ...
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Khaw, Kay-Tee
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Wareham, Nichola ...
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Bradbury, Kathry ...
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Trichopoulou, An ...
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Lagiou, Pagona
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Trichopoulos, Di ...
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Palli, Domenico
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Krogh, Vittorio
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Tumino, Rosario
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Naccarati, Aless ...
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Panico, Salvator ...
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Siersema, Peter ...
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Peeters, Petra H ...
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Ljuslinder, Ingr ...
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Johansson, Ingeg ...
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Ericson, Ulrika
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Ohlsson, Bodil
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Weiderpass, Elis ...
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Skeie, Guri
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Borch, Kristin
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Rinaldi, Sabina
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Romieu, Isabelle
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Kong, Joyce
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Gunter, Marc J
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Ward, Heather A
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Riboli, Elio
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Boeing, Heiner
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MEDICAL AND HEAL ...
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and Cancer and Oncol ...
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MEDICAL AND HEAL ...
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- Articles in the publication
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BMC Medicine
- By the university
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Umeå University
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Lund University
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Karolinska Institutet