Healthy Lifestyle and Risk of Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort Study
Healthy Lifestyle and Risk of Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort Study
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DOI：
10.1097/md.0000000000002850
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发表时间：
2016-04-01
期刊：
影响因子：
1.6
通讯作者：
Romieu, Isabelle
中科院分区：
文献类型：
--
作者：
McKenzie, Fiona;Biessy, Carine;Romieu, Isabelle
据估计，至少三分之一的最常见癌症与生活方式有关，因此是可以预防的。关键的可改变的生活方式因素已被单独与癌症的风险，然而，这些因素的综合影响知之甚少，这项研究产生了一个健康的生活方式指数评分（HLIS）调查的可改变的因素对整体癌症的风险，酒精相关的癌症，烟草相关的癌症，肥胖相关的癌症和生殖相关的癌症的联合影响。该研究包括来自多国欧洲癌症和营养前瞻性调查（EPIC）队列的391，608名男性和女性。HLIS由基线时评估的5个因素（饮食、体力活动、吸烟、饮酒和人体测量）构建，每个因素的类别评分为0至4分，数值越高表示行为越健康。用考克斯比例回归估计风险比（HR），用调整后的模型估计人群归因分数（PAF）。（调整后的HR 0.952，95%置信区间（CI）：0.946，0.958），男性和4%（校正HR 0.961，95% CI：0.956，0.966）。在所有癌症中，第四类与第二类HLIS相比，男性和女性的风险分别降低了28%和24%，酒精相关的风险降低了41%和33%，烟草相关的风险降低了49%和46%，肥胖相关的风险降低了41%和26%，研究结果表明，简单的行为改变可能对癌症预防产生相当大的影响，特别是对男性。
It has been estimated that at least a third of the most common cancers are related to lifestyle and as such are preventable. Key modifiable lifestyle factors have been individually associated with cancer risk; however, less is known about the combined effects of these factors.This study generated a healthy lifestyle index score (HLIS) to investigate the joint effect of modifiable factors on the risk of overall cancers, alcohol-related cancers, tobacco-related cancers, obesity-related cancers, and reproductive-related cancers. The study included 391,608 men and women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The HLIS was constructed from 5 factors assessed at baseline (diet, physical activity, smoking, alcohol consumption, and anthropometry) by assigning scores of 0 to 4 to categories of each factor, for which higher values indicate healthier behaviors. Hazard ratios (HR) were estimated by Cox proportional regression and population attributable fractions (PAFs) estimated from the adjusted models.There was a 5% lower risk (adjusted HR 0.952, 95% confidence interval (CI): 0.946, 0.958) of all cancers per point score of the index for men and 4% (adjusted HR 0.961, 95% CI: 0.956, 0.966) for women. The fourth versus the second category of the HLIS was associated with a 28% and 24% lower risk for men and women respectively across all cancers, 41% and 33% for alcohol-related, 49% and 46% for tobacco-related, 41% and 26% for obesity-related, and 21% for female reproductive cancers.Findings suggest simple behavior modifications could have a sizeable impact on cancer prevention, especially for men.