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 - 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.
KW - Weight change
KW - Imputation
KW - Health
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 -
