Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the women's health initiative.
Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the women's health initiative.
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DOI：
10.1158/1940-6207.capr-13-0258
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发表时间：
2014-01
期刊：
影响因子：
--
通讯作者：
Neuhouser ML
中科院分区：
文献类型：
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作者：
Thomson CA;McCullough ML;Wertheim BC;Chlebowski RT;Martinez ME;Stefanick ML;Rohan TE;Manson JE;Tindle HA;Ockene J;Vitolins MZ;Wactawski-Wende J;Sarto GE;Lane DS;Neuhouser ML
健康的生活方式可以降低癌症风险和总体死亡率。坚持癌症预防健康行为和随后的癌症风险尚未在绝经后妇女的不同样本中进行评估。我们研究了美国癌症协会（ACS）营养和体育活动癌症预防指南评分与65838名参加妇女健康倡议观察研究的绝经后妇女的癌症发病率、癌症特异性死亡率和全因死亡率之间的关系。ACS指南得分（0-8分）由饮食、身体活动、体重指数（当前和18岁时）和饮酒量的综合测量确定。在平均12.6年的随访后，确定了8632例癌症事件和2356例癌症死亡。与最低的ACS指南评分相比，最高的ACS指南评分与任何癌症风险降低17%相关[HR， 0.83；95%可信区间（CI）， 0.75-0.92]，乳腺癌风险降低22% (HR, 0.78; 95% CI, 0.67-0.92)，结直肠癌风险降低52% (HR, 0.48; 95% CI, 0.32-0.73)，全因死亡率风险降低27%，癌症特异性死亡率风险降低20% （HR, 0.80; 95% CI, 0.71-0.90）。癌症发病率和死亡率较低的相关性在亚洲、黑人和西班牙裔女性中最强，在非西班牙裔白人中最弱。与营养和身体活动癌症预防指南相一致的行为与绝经后妇女患乳腺癌和结直肠癌的风险降低以及癌症特异性死亡率降低相关。
Healthy lifestyle behaviors are recommended to reduce cancer risk and overall mortality. Adherence to cancer-preventive health behaviors and subsequent cancer risk has not been evaluated in a diverse sample of postmenopausal women. We examined the association between the American Cancer Society (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines score and risk of incident cancer, cancer-specific mortality, and all-cause mortality in 65,838 postmenopausal women enrolled in the Women’s Health Initiative Observational Study. ACS guidelines scores (0–8 points) were determined from a combined measure of diet, physical activity, body mass index (current and at age 18 years), and alcohol consumption. After a mean follow-up of 12.6 years, 8,632 incident cancers and 2,356 cancer deaths were identified. The highest ACS guidelines scores compared with the lowest were associated with a 17% lower risk of any cancer [HR, 0.83; 95% confidence interval (CI), 0.75–0.92], 22% lower risk of breast cancer (HR, 0.78; 95% CI, 0.67–0.92), 52% lower risk of colorectal cancer (HR, 0.48; 95% CI, 0.32–0.73), 27% lower risk of all-cause mortality, and 20% lower risk of cancer-specific mortality (HR, 0.80; 95% CI, 0.71–0.90). Associations with lower cancer incidence and mortality were generally strongest among Asian, black, and Hispanic women and weakest among non-Hispanic whites. Behaviors concordant with Nutrition and Physical Activity Cancer Prevention Guidelines were associated with lower risk of total, breast, and colorectal cancers and lower cancer-specific mortality in postmenopausal women.