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; 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

doi:10.1186/s12916-014-0168-4

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 ChirlaqueAurelio 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

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

27 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 language	English
Article number	168
Journal	BMC Medicine
Volume	12
Issue number	1
DOIs	https://doi.org/10.1186/s12916-014-0168-4
Publication status	Published - 10 Oct 2014

Keywords

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

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10.1186/s12916-014-0168-4

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Aleksandrova, K., Pischon, T., Jenab, M., Bueno-de-Mesquita, H. B., Fedirko, V., Norat, T., Romaguera, D., Knüppel, S., Boutron-Ruault, M. C., Dossus, L., Dartois, L., Kaaks, R., Li, K., Tjønneland, A., Overvad, K., Quirós, J. R., Buckland, G., Sánchez, M. J., Dorronsoro, M., ... Boeing, H. (2014). Combined impact of healthy lifestyle factors on colorectal cancer: A large European cohort study. BMC Medicine, 12(1), Article 168. https://doi.org/10.1186/s12916-014-0168-4

@article{b30e2a8d8d144c75bce64c2e2a869a68,

title = "Combined impact of healthy lifestyle factors on colorectal cancer: A large European cohort study",

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 ",

keywords = "colorectal cancer, combined impact, European Prospective Investigation into Cancer and Nutrition (EPIC), lifestyle factors, population attributable risks",

author = "Krasimira Aleksandrova and Tobias Pischon and Mazda Jenab and Bueno-de-Mesquita, {H. B.} and Veronika Fedirko and Teresa Norat and Dora Romaguera and Sven Kn{\"u}ppel and Boutron-Ruault, {Marie Christine} and Laure Dossus and Laureen Dartois and Rudolf Kaaks and Kuanrong Li and Anne Tj{\o}nneland and Kim Overvad and Quir{\'o}s, {Jos{\'e} R.} and Genevieve Buckland and S{\'a}nchez, {Mar{\'i}a J.} and Miren Dorronsoro and Chirlaque, {Maria Dolores} and Aurelio Barricarte and Khaw, {Kay Tee} and Wareham, {Nicholas J.} and Bradbury, {Kathryn E.} and Antonia Trichopoulou and Pagona Lagiou and Dimitrios Trichopoulos and Domenico Palli and Vittorio Krogh and Rosario Tumino and Alessio Naccarati and Salvatore Panico and Siersema, {Peter D.} and Peeters, {Petra H M} and Ingrid Ljuslinder and Ingegerd Johansson and Ulrika Ericson and Bodil Ohlsson and Elisabete Weiderpass and Guri Skeie and Borch, {Kristin B.} and Sabina Rinaldi and Isabelle Romieu and Joyce Kong and Gunter, {Marc J.} and Ward, {Heather A.} and Elio Riboli and Heiner Boeing",

year = "2014",

month = oct,

day = "10",

doi = "10.1186/s12916-014-0168-4",

language = "English",

volume = "12",

journal = "BMC Medicine",

issn = "1741-7015",

publisher = "BioMed Central Ltd.",

number = "1",

}

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

TY - JOUR

T1 - Combined impact of healthy lifestyle factors on colorectal cancer

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

AB - 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

KW - colorectal cancer

KW - combined impact

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

KW - lifestyle factors

KW - population attributable risks

UR - http://www.scopus.com/inward/record.url?scp=84907952984&partnerID=8YFLogxK

U2 - 10.1186/s12916-014-0168-4

DO - 10.1186/s12916-014-0168-4

M3 - Article

C2 - 25319089

SN - 1741-7015

VL - 12

JO - BMC Medicine

JF - BMC Medicine

IS - 1

M1 - 168

ER -

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

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