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

• Published in: BMC medicine 2014-10, Vol.12 (1), p.168-168, Article 168
• Main Authors: Aleksandrova, Krasimira, Pischon, Tobias, Jenab, Mazda, Bueno-de-Mesquita, H Bas, Fedirko, Veronika, Norat, Teresa, Romaguera, Dora, Knüppel, Sven, Boutron-Ruault, Marie-Christine, Dossus, Laure, Dartois, Laureen, Kaaks, Rudolf, Li, Kuanrong, Tjønneland, Anne, Overvad, Kim, Quirós, José Ramón, Buckland, Genevieve, Sánchez, María José, 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
• Format: Article
• Language: English
• Subjects: acrylamide; Adult; Aged; Aircraft industry; Alcohol Drinking; biomarkers; Cancer and Oncology; Cancer och onkologi; Clinical medical disciplines: 750; Clinical Medicine; Cohort Studies; Colorectal cancer; Colorectal Neoplasms - psychology; combined impact; Community medicine, Social medicine: 801; Diet; dietary questionnaires; Endocrinology and Diabetes; Endokrinologi och diabetes; Epidemiology; Europe - epidemiology; European Prospective Investigation into Cancer and; European Prospective Investigation into Cancer and Nutrition (EPIC); Exercise; Female; haemoglobin adducts; Health aspects; Health Behavior; Health risk assessment; Health sciences: 800; Helsefag: 800; Humans; Incidence; Klinisk medicin; Klinisk medisinske fag: 750; Life Style; lifestyle factors; Male; measurement errors; Medical and Health Sciences; Medical disciplines: 700; Medical research; Medicin och hälsovetenskap; Medisinske Fag: 700; Middle Aged; Nutrition (EPIC); Oncology: 762; Onkologi: 762; Physical fitness; population attributable risks; Proportional Hazards Models; Prospective Studies; Risk Factors; Samfunnsmedisin, sosialmedisin: 801; smoking; VDP; White People
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-014-0168-4

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. 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. 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