TY - JOUR
T1 - Changes in Lifestyle and Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition
AU - Botteri, Edoardo
AU - Peveri, Giulia
AU - Berstad, Paula
AU - Bagnardi, Vincenzo
AU - Chen, Sairah L.F.
AU - Sandanger, Torkjel M.
AU - Hoff, Geir
AU - Dahm, Christina C.
AU - Antoniussen, Christian S.
AU - Tjønneland, Anne
AU - Eriksen, Anne Kirstine
AU - Skeie, Guri
AU - Perez-Cornago, Aurora
AU - Huerta, José María
AU - Jakszyn, Paula
AU - Harlid, Sophia
AU - Sundström, Björn
AU - Barricarte, Aurelio
AU - Monninkhof, Evelyn M.
AU - Derksen, Jeroen W.G.
AU - Schulze, Matthias B.
AU - Bueno-De-Mesquita, Bas
AU - Sánchez, Maria Jose
AU - Cross, Amanda J.
AU - Tsilidis, Konstantinos K.
AU - De Magistris, Maria Santucci
AU - Kaaks, Rudolf
AU - Katzke, Verena
AU - Rothwell, Joseph A.
AU - Laouali, Nasser
AU - Severi, Gianluca
AU - Amiano, Pilar
AU - Contiero, Paolo
AU - Sacerdote, Carlotta
AU - Goldberg, Marcel
AU - Touvier, Mathilde
AU - Freisling, Heinz
AU - Viallon, Vivian
AU - Weiderpass, Elisabete
AU - Riboli, Elio
AU - Gunter, Marc J.
AU - Jenab, Mazda
AU - Ferrari, Pietro
N1 - Funding Information:
Financial support: The study was supported by the grant LIBERTY (AAP SHS-E-SP 2020, PI: P Ferrari) from the French Institut National du Cancer (INCa). The coordination of EPIC is financially supported by International Agency for Research on Cancer (IARC) and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, and Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), and Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Compagnia di SanPaolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), and Statistics Netherlands (The Netherlands); Health Research Fund (FIS)—nstituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology (ICO) (Spain); Swedish Cancer Society and Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); and Cancer Research UK (14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford) and Medical Research Council (1000143 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford) (United Kingdom).
Publisher Copyright:
© 2022 by The American College of Gastroenterology.
PY - 2023/4/1
Y1 - 2023/4/1
N2 - Introduction: We investigated the impact of changes in lifestyle habits on colorectal cancer (CRC) risk in a multicountry European cohort. Methods: We used baseline and follow-up questionnaire data from the European Prospective Investigation into Cancer cohort to assess changes in lifestyle habits and their associations with CRC development. We calculated a healthy lifestyle index (HLI) score based on smoking status, alcohol consumption, body mass index, and physical activity collected at the 2 time points. HLI ranged from 0 (most unfavorable) to 16 (most favorable). We estimated the association between HLI changes and CRC risk using Cox regression models and reported hazard ratios (HR) with 95% confidence intervals (CI). Results: Among 295,865 participants, 2,799 CRC cases were observed over a median of 7.8 years. The median time between questionnaires was 5.7 years. Each unit increase in HLI from the baseline to the follow-up assessment was associated with a statistically significant 3% lower CRC risk. Among participants in the top tertile at baseline (HLI > 11), those in the bottom tertile at follow-up (HLI ≤ 9) had a higher CRC risk (HR 1.34; 95% CI 1.02-1.75) than those remaining in the top tertile. Among individuals in the bottom tertile at baseline, those in the top tertile at follow-up had a lower risk (HR 0.77; 95% CI 0.59-1.00) than those remaining in the bottom tertile. Discussion: Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention.
AB - Introduction: We investigated the impact of changes in lifestyle habits on colorectal cancer (CRC) risk in a multicountry European cohort. Methods: We used baseline and follow-up questionnaire data from the European Prospective Investigation into Cancer cohort to assess changes in lifestyle habits and their associations with CRC development. We calculated a healthy lifestyle index (HLI) score based on smoking status, alcohol consumption, body mass index, and physical activity collected at the 2 time points. HLI ranged from 0 (most unfavorable) to 16 (most favorable). We estimated the association between HLI changes and CRC risk using Cox regression models and reported hazard ratios (HR) with 95% confidence intervals (CI). Results: Among 295,865 participants, 2,799 CRC cases were observed over a median of 7.8 years. The median time between questionnaires was 5.7 years. Each unit increase in HLI from the baseline to the follow-up assessment was associated with a statistically significant 3% lower CRC risk. Among participants in the top tertile at baseline (HLI > 11), those in the bottom tertile at follow-up (HLI ≤ 9) had a higher CRC risk (HR 1.34; 95% CI 1.02-1.75) than those remaining in the top tertile. Among individuals in the bottom tertile at baseline, those in the top tertile at follow-up had a lower risk (HR 0.77; 95% CI 0.59-1.00) than those remaining in the bottom tertile. Discussion: Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention.
UR - http://www.scopus.com/inward/record.url?scp=85151312824&partnerID=8YFLogxK
U2 - 10.14309/ajg.0000000000002065
DO - 10.14309/ajg.0000000000002065
M3 - Article
C2 - 36227801
AN - SCOPUS:85151312824
SN - 1572-0241
VL - 118
SP - 702
EP - 711
JO - The American journal of gastroenterology
JF - The American journal of gastroenterology
IS - 4
ER -
