Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

Genevieve Buckland; N. Travier; J. M. Huerta; H. B. Bueno-De-Mesquita; P. D. Siersema; G. Skeie; E. Weiderpass; D. Engeset; U. Ericson; B. Ohlsson; A. Agudo; I. Romieu; P. Ferrari; H. Freisling; S. Colorado-Yohar; K. Li; R. Kaaks; V. Pala; A. J. Cross; E. Riboli; A. Trichopoulou; P. Lagiou; C. Bamia; M. C. Boutron-Ruault; G. Fagherazzi; L. Dartois; A. M. May; P. H. Peeters; S. Panico; M. Johansson; B. Wallner; D. Palli; T. J. Key; K. T. Khaw; E. Ardanaz; K. Overvad; A. Tjønneland; M. Dorronsoro; M. J. Sánchez; J. R. Quirós; A. Naccarati; R. Tumino; H. Boeing; C. A. Gonzalez

doi:10.1002/ijc.29411

Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

Genevieve Buckland^*, N. Travier, J. M. Huerta, H. B. Bueno-De-Mesquita, P. D. Siersema, G. Skeie, E. Weiderpass, D. Engeset, U. Ericson, B. Ohlsson, A. Agudo, I. Romieu, P. Ferrari, H. Freisling, S. Colorado-Yohar, K. Li, R. Kaaks, V. Pala, A. J. Cross, E. RiboliA. Trichopoulou, P. Lagiou, C. Bamia, M. C. Boutron-Ruault, G. Fagherazzi, L. Dartois, A. M. May, P. H. Peeters, S. Panico, M. Johansson, B. Wallner, D. Palli, T. J. Key, K. T. Khaw, E. Ardanaz, K. Overvad, A. Tjønneland, M. Dorronsoro, M. J. Sánchez, J. R. Quirós, A. Naccarati, R. Tumino, H. Boeing, C. A. Gonzalez

^*Corresponding author for this work

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

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Abstract

Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trends<0.001. Population attributable risk calculations showed that 18.8% of all GC and 62.4% of cardia GC cases could have been prevented if participants in this population had followed the healthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC.

Original language	English
Pages (from-to)	598-606
Number of pages	9
Journal	International Journal of Cancer
Volume	137
Issue number	3
DOIs	https://doi.org/10.1002/ijc.29411
Publication status	Published - 1 Aug 2015

Keywords

cohort
EPIC
gastric cancer
healthy lifestyle score

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Buckland, G., Travier, N., Huerta, J. M., Bueno-De-Mesquita, H. B., Siersema, P. D., Skeie, G., Weiderpass, E., Engeset, D., Ericson, U., Ohlsson, B., Agudo, A., Romieu, I., Ferrari, P., Freisling, H., Colorado-Yohar, S., Li, K., Kaaks, R., Pala, V., Cross, A. J., ... Gonzalez, C. A. (2015). Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study. International Journal of Cancer, 137(3), 598-606. https://doi.org/10.1002/ijc.29411

@article{264606a241df4cc4851dd008070c8f73,

title = "Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study",

abstract = "Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trends<0.001. Population attributable risk calculations showed that 18.8% of all GC and 62.4% of cardia GC cases could have been prevented if participants in this population had followed the healthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC.",

keywords = "cohort, EPIC, gastric cancer, healthy lifestyle score",

author = "Genevieve Buckland and N. Travier and Huerta, {J. M.} and Bueno-De-Mesquita, {H. B.} and Siersema, {P. D.} and G. Skeie and E. Weiderpass and D. Engeset and U. Ericson and B. Ohlsson and A. Agudo and I. Romieu and P. Ferrari and H. Freisling and S. Colorado-Yohar and K. Li and R. Kaaks and V. Pala and Cross, {A. J.} and E. Riboli and A. Trichopoulou and P. Lagiou and C. Bamia and Boutron-Ruault, {M. C.} and G. Fagherazzi and L. Dartois and May, {A. M.} and Peeters, {P. H.} and S. Panico and M. Johansson and B. Wallner and D. Palli and Key, {T. J.} and Khaw, {K. T.} and E. Ardanaz and K. Overvad and A. Tj{\o}nneland and M. Dorronsoro and S{\'a}nchez, {M. J.} and Quir{\'o}s, {J. R.} and A. Naccarati and R. Tumino and H. Boeing and Gonzalez, {C. A.}",

year = "2015",

month = aug,

day = "1",

doi = "10.1002/ijc.29411",

language = "English",

volume = "137",

pages = "598--606",

journal = "International Journal of Cancer",

issn = "0020-7136",

publisher = "John Wiley & Sons Inc.",

number = "3",

}

Buckland, G, Travier, N, Huerta, JM, Bueno-De-Mesquita, HB, Siersema, PD, Skeie, G, Weiderpass, E, Engeset, D, Ericson, U, Ohlsson, B, Agudo, A, Romieu, I, Ferrari, P, Freisling, H, Colorado-Yohar, S, Li, K, Kaaks, R, Pala, V, Cross, AJ, Riboli, E, Trichopoulou, A, Lagiou, P, Bamia, C, Boutron-Ruault, MC, Fagherazzi, G, Dartois, L, May, AM, Peeters, PH, Panico, S, Johansson, M, Wallner, B, Palli, D, Key, TJ, Khaw, KT, Ardanaz, E, Overvad, K, Tjønneland, A, Dorronsoro, M, Sánchez, MJ, Quirós, JR, Naccarati, A, Tumino, R, Boeing, H & Gonzalez, CA 2015, 'Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study', International Journal of Cancer, vol. 137, no. 3, pp. 598-606. https://doi.org/10.1002/ijc.29411

TY - JOUR

T1 - Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

AU - Buckland, Genevieve

AU - Travier, N.

AU - Huerta, J. M.

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

AU - Siersema, P. D.

AU - Skeie, G.

AU - Weiderpass, E.

AU - Engeset, D.

AU - Ericson, U.

AU - Ohlsson, B.

AU - Agudo, A.

AU - Romieu, I.

AU - Ferrari, P.

AU - Freisling, H.

AU - Colorado-Yohar, S.

AU - Li, K.

AU - Kaaks, R.

AU - Pala, V.

AU - Cross, A. J.

AU - Riboli, E.

AU - Trichopoulou, A.

AU - Lagiou, P.

AU - Bamia, C.

AU - Boutron-Ruault, M. C.

AU - Fagherazzi, G.

AU - Dartois, L.

AU - May, A. M.

AU - Peeters, P. H.

AU - Panico, S.

AU - Johansson, M.

AU - Wallner, B.

AU - Palli, D.

AU - Key, T. J.

AU - Khaw, K. T.

AU - Ardanaz, E.

AU - Overvad, K.

AU - Tjønneland, A.

AU - Dorronsoro, M.

AU - Sánchez, M. J.

AU - Quirós, J. R.

AU - Naccarati, A.

AU - Tumino, R.

AU - Boeing, H.

AU - Gonzalez, C. A.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trends<0.001. Population attributable risk calculations showed that 18.8% of all GC and 62.4% of cardia GC cases could have been prevented if participants in this population had followed the healthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC.

AB - Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trends<0.001. Population attributable risk calculations showed that 18.8% of all GC and 62.4% of cardia GC cases could have been prevented if participants in this population had followed the healthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC.

KW - cohort

KW - EPIC

KW - gastric cancer

KW - healthy lifestyle score

UR - http://www.scopus.com/inward/record.url?scp=84929518823&partnerID=8YFLogxK

U2 - 10.1002/ijc.29411

DO - 10.1002/ijc.29411

M3 - Article

C2 - 25557932

AN - SCOPUS:84929518823

SN - 0020-7136

VL - 137

SP - 598

EP - 606

JO - International Journal of Cancer

JF - International Journal of Cancer

IS - 3

ER -

Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

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Keywords

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