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Título
Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study
Autor(es)
Aleksandrova, Krasimira | Pischon, Tobias | Jenab, Mazda | Bueno-de-Mesquita, H. Bas | Fedirko, Veronika | Norat, Teresa | Romaguera, DoraAutor/a del sistema sanitario público de las Islas Baleares Orcid | Knueppel, Sven | Boutron-Ruault, Marie-Christine | Dossus, Laure | Dartois, Laureen | Kaaks, Rudolf | Li, Kuanrong | Tjonneland, Anne | Overvad, Kim | Quiros, Jose Ramon | Buckland, Genevieve | Sanchez, Maria Jose | Dorronsoro, Miren | Chirlaque, Maria-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 | Borch, Kristin Benjaminsen | Rinaldi, Sabina | Romieu, Isabelle | Kong, Joyce | Gunter, Marc J. | Ward, Heather A. | Riboli, Elio | Boeing, Heiner
Fecha de publicación
2014-10-10
Cita
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.
Idioma
Inglés
Tipo de documento
research article
Resumen
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.
Palabras clave
Lifestyle factors | Combined impact | Population attributable risks | Colorectal cancer | European Prospective Investigation into Cancer and Nutrition (EPIC)
MESH
Aged | European 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 Cohortes | Incidencia | 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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