Combined impact of healthy lifestyle factors on colorectal cancer

A large European cohort study

Krasimira Aleksandrova, Tobias Pischon, Mazda Jenab, H. B. Bueno-de-Mesquita, Veronika Fedirko, Teresa Norat, Dora Romaguera, Sven Knüppel, Marie Christine Boutron-Ruault, Laure Dossus, Laureen Dartois, Rudolf Kaaks, Kuanrong Li, Anne Tjønneland, Kim Overvad, José R. Quirós, Genevieve Buckland, María J. Sánchez, Miren Dorronsoro, Maria Dolores Chirlaque & 28 others Aurelio Barricarte, Kay Tee Khaw, Nicholas J. Wareham, Kathryn E. Bradbury, Antonia Trichopoulou, Pagona Lagiou, Dimitrios Trichopoulos, Domenico Palli, Vittorio Krogh, Rosario Tumino, Alessio Naccarati, Salvatore Panico, Peter D. Siersema, Petra H M Peeters, Ingrid Ljuslinder, Ingegerd Johansson, Ulrika Ericson, Bodil Ohlsson, Elisabete Weiderpass, Guri Skeie, Kristin B. Borch, Sabina Rinaldi, Isabelle Romieu, Joyce Kong, Marc J. Gunter, Heather A. Ward, Elio Riboli, Heiner Boeing

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

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

Original languageEnglish
Article number168
JournalBMC Medicine
Volume12
Issue number1
DOIs
Publication statusPublished - Oct 10 2014

Fingerprint

Colorectal Neoplasms
Cohort Studies
Confidence Intervals
Alcohol Drinking
Exercise
Sex Education
Proportional Hazards Models
Life Style
Neoplasms
Smoking
Body Weight
Healthy Lifestyle
Weights and Measures
Incidence
Population

Keywords

  • colorectal cancer
  • combined impact
  • European Prospective Investigation into Cancer and Nutrition (EPIC)
  • lifestyle factors
  • population attributable risks

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Aleksandrova, K., Pischon, T., Jenab, M., Bueno-de-Mesquita, H. B., Fedirko, V., Norat, T., ... Boeing, H. (2014). Combined impact of healthy lifestyle factors on colorectal cancer: A large European cohort study. BMC Medicine, 12(1), [168]. https://doi.org/10.1186/s12916-014-0168-4

Combined impact of healthy lifestyle factors on colorectal cancer : A large European cohort study. / Aleksandrova, Krasimira; Pischon, Tobias; Jenab, Mazda; Bueno-de-Mesquita, H. B.; 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 R.; Buckland, Genevieve; Sánchez, María J.; 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 B.; Rinaldi, Sabina; Romieu, Isabelle; Kong, Joyce; Gunter, Marc J.; Ward, Heather A.; Riboli, Elio; Boeing, Heiner.

In: BMC Medicine, Vol. 12, No. 1, 168, 10.10.2014.

Research output: Contribution to journalArticle

Aleksandrova, K, Pischon, T, Jenab, M, Bueno-de-Mesquita, HB, Fedirko, V, Norat, T, Romaguera, D, Knüppel, S, Boutron-Ruault, MC, Dossus, L, Dartois, L, Kaaks, R, Li, K, Tjønneland, A, Overvad, K, Quirós, JR, Buckland, G, Sánchez, MJ, Dorronsoro, M, Chirlaque, MD, Barricarte, A, Khaw, KT, Wareham, NJ, Bradbury, KE, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Palli, D, Krogh, V, Tumino, R, Naccarati, A, Panico, S, Siersema, PD, Peeters, PHM, Ljuslinder, I, Johansson, I, Ericson, U, Ohlsson, B, Weiderpass, E, Skeie, G, Borch, KB, Rinaldi, S, Romieu, I, Kong, J, Gunter, MJ, Ward, HA, Riboli, E & Boeing, H 2014, 'Combined impact of healthy lifestyle factors on colorectal cancer: A large European cohort study', BMC Medicine, vol. 12, no. 1, 168. https://doi.org/10.1186/s12916-014-0168-4
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 Medicine. 2014 Oct 10;12(1). 168. https://doi.org/10.1186/s12916-014-0168-4
Aleksandrova, Krasimira ; Pischon, Tobias ; Jenab, Mazda ; Bueno-de-Mesquita, H. B. ; 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 R. ; Buckland, Genevieve ; Sánchez, María J. ; 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 B. ; Rinaldi, Sabina ; Romieu, Isabelle ; Kong, Joyce ; Gunter, Marc J. ; Ward, Heather A. ; Riboli, Elio ; Boeing, Heiner. / Combined impact of healthy lifestyle factors on colorectal cancer : A large European cohort study. In: BMC Medicine. 2014 ; Vol. 12, No. 1.
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abstract = "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",
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T2 - A large European cohort study

AU - Aleksandrova, Krasimira

AU - Pischon, Tobias

AU - Jenab, Mazda

AU - Bueno-de-Mesquita, H. B.

AU - Fedirko, Veronika

AU - Norat, Teresa

AU - Romaguera, Dora

AU - Knüppel, Sven

AU - Boutron-Ruault, Marie Christine

AU - Dossus, Laure

AU - Dartois, Laureen

AU - Kaaks, Rudolf

AU - Li, Kuanrong

AU - Tjønneland, Anne

AU - Overvad, Kim

AU - Quirós, José R.

AU - Buckland, Genevieve

AU - Sánchez, María J.

AU - Dorronsoro, Miren

AU - Chirlaque, Maria Dolores

AU - Barricarte, Aurelio

AU - Khaw, Kay Tee

AU - Wareham, Nicholas J.

AU - Bradbury, Kathryn E.

AU - Trichopoulou, Antonia

AU - Lagiou, Pagona

AU - Trichopoulos, Dimitrios

AU - Palli, Domenico

AU - Krogh, Vittorio

AU - Tumino, Rosario

AU - Naccarati, Alessio

AU - Panico, Salvatore

AU - Siersema, Peter D.

AU - Peeters, Petra H M

AU - Ljuslinder, Ingrid

AU - Johansson, Ingegerd

AU - Ericson, Ulrika

AU - Ohlsson, Bodil

AU - Weiderpass, Elisabete

AU - Skeie, Guri

AU - Borch, Kristin B.

AU - Rinaldi, Sabina

AU - Romieu, Isabelle

AU - Kong, Joyce

AU - Gunter, Marc J.

AU - Ward, Heather A.

AU - Riboli, Elio

AU - Boeing, Heiner

PY - 2014/10/10

Y1 - 2014/10/10

N2 - 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

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KW - combined impact

KW - European Prospective Investigation into Cancer and Nutrition (EPIC)

KW - lifestyle factors

KW - population attributable risks

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