Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study

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Aleksandrova, Krasimira (author)

Combined impact of healthy lifestyle factors on colorectal cancer : a large European cohort study

Article/chapterEnglish2014

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2014-10-10
BioMed Central,2014
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:umu-95215
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-95215URI
https://doi.org/10.1186/s12916-014-0168-4DOI
https://lup.lub.lu.se/record/4868355URI
http://kipublications.ki.se/Default.aspx?queryparsed=id:130078099URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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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 and genre

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
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)

Added entries (persons, corporate bodies, meetings, titles ...)

Pischon, Tobias (author)
Jenab, Mazda (author)
Bueno-de-Mesquita, H Bas (author)
Fedirko, Veronika (author)
Norat, Teresa (author)
Romaguera, Dora (author)
Knüppel, Sven (author)
Boutron-Ruault, Marie-Christine (author)
Dossus, Laure (author)
Dartois, Laureen (author)
Kaaks, Rudolf (author)
Li, Kuanrong (author)
Tjønneland, Anne (author)
Overvad, Kim (author)
Quirós, José Ramón (author)
Buckland, Genevieve (author)
Sánchez, María José (author)
Dorronsoro, Miren (author)
Chirlaque, Maria-Dolores (author)
Barricarte, Aurelio (author)
Khaw, Kay-Tee (author)
Wareham, Nicholas J (author)
Bradbury, Kathryn E (author)
Trichopoulou, Antonia (author)
Lagiou, Pagona (author)
Trichopoulos, Dimitrios (author)
Palli, Domenico (author)
Krogh, Vittorio (author)
Tumino, Rosario (author)
Naccarati, Alessio (author)
Panico, Salvatore (author)
Siersema, Peter D (author)
Peeters, Petra HM (author)
Ljuslinder, IngridUmeå universitet,Onkologi(Swepub:umu)inlj0001 (author)
Johansson, IngegerdUmeå universitet,Institutionen för odontologi(Swepub:umu)injo0003 (author)
Ericson, UlrikaLund University,Lunds universitet,Diabetes - kardiovaskulär sjukdom,Forskargrupper vid Lunds universitet,Diabetes - Cardiovascular Disease,Lund University Research Groups(Swepub:lu)medf-upe (author)
Ohlsson, BodilLund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups(Swepub:lu)kir-boh (author)
Weiderpass, ElisabeteKarolinska Institutet (author)
Skeie, Guri (author)
Borch, Kristin (author)
Rinaldi, Sabina (author)
Romieu, Isabelle (author)
Kong, Joyce (author)
Gunter, Marc J (author)
Ward, Heather A (author)
Riboli, Elio (author)
Boeing, Heiner (author)
Umeå universitetOnkologi (creator_code:org_t)

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In:BMC Medicine: BioMed Central12:1, s. 168-1741-7015

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By the author/editor: Aleksandrova, Kr ...; Pischon, Tobias; Jenab, Mazda; Bueno-de-Mesquit ...; Fedirko, Veronik ...; Norat, Teresa; show more...; Romaguera, Dora; Knüppel, Sven; Boutron-Ruault, ...; Dossus, Laure; Dartois, Laureen; Kaaks, Rudolf; Li, Kuanrong; Tjønneland, Anne; Overvad, Kim; Quirós, José Ram ...; Buckland, Genevi ...; Sánchez, María J ...; Dorronsoro, Mire ...; Chirlaque, Maria ...; Barricarte, Aure ...; Khaw, Kay-Tee; Wareham, Nichola ...; Bradbury, Kathry ...; Trichopoulou, An ...; Lagiou, Pagona; Trichopoulos, Di ...; Palli, Domenico; Krogh, Vittorio; Tumino, Rosario; Naccarati, Aless ...; Panico, Salvator ...; Siersema, Peter ...; Peeters, Petra H ...; Ljuslinder, Ingr ...; Johansson, Ingeg ...; Ericson, Ulrika; Ohlsson, Bodil; Weiderpass, Elis ...; Skeie, Guri; Borch, Kristin; Rinaldi, Sabina; Romieu, Isabelle; Kong, Joyce; Gunter, Marc J; Ward, Heather A; Riboli, Elio; Boeing, Heiner; show less...

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