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

  1. Aleksandrova, Krasimira
  2. Pischon, Tobias
  3. Jenab, Mazda
  4. Bas Bueno-de-Mesquita, H.
  5. Fedirko, Veronika
  6. Norat, Teresa
  7. Romaguera, Dora
  8. Knüppel, Sven
  9. Butron-Ruault, Marie-Christine
  10. Dossus, Laure
  11. Dartois, Laureen
  12. Kaaks, Rudolf
  13. Li, Kuanrong
  14. Tjonneland, Anne
  15. Overvad, Kim
  16. Quirós, José Ramón
  17. Buckland, Genevieve
  18. Sánchez, María José
  19. Dorronsoro, Miren
  20. Chirlaque, Maria-Dolores
  21. Barricarte, Aurelio
  22. Khaw, Kay-Tee
  23. Wareham, Nicholas J.
  24. Bradbury, Kathryn E.
  25. Trichopoulou, Antonia
  26. Lagiou, Pagona
  27. Trichopoulos, Dimitri
  28. Palli, Domenico
  29. Krogh, Vittorio
  30. Tumino, Rosario
  31. Naccarati, Alessio
  32. Panico, Salvatore
  33. Siersema, Peter D.
  34. Peeters, Petra H.M.
  35. Ljuslinder, Ingrid
  36. Johansson, Ingegerd
  37. Ericson, Ulrika
  38. Ohlsson, Bodil
  39. Weiderpass, Elisabete
  40. Skeie, Guri
  41. Benjaminsen Borch, Kristin
  42. Rinaldi, Sabina
  43. Romieu, Isabelle
  44. Kong, Joyce
  45. Gunter, Marc J.
  46. Ward, Heather A.
  47. Riboli, Elio
  48. Boeing, Heiner ORCID logo

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1000 Titel
  • Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study
1000 Autor/in
  1. Aleksandrova, Krasimira |
  2. Pischon, Tobias |
  3. Jenab, Mazda |
  4. Bas Bueno-de-Mesquita, H. |
  5. Fedirko, Veronika |
  6. Norat, Teresa |
  7. Romaguera, Dora |
  8. Knüppel, Sven |
  9. Butron-Ruault, Marie-Christine |
  10. Dossus, Laure |
  11. Dartois, Laureen |
  12. Kaaks, Rudolf |
  13. Li, Kuanrong |
  14. Tjonneland, Anne |
  15. Overvad, Kim |
  16. Quirós, José Ramón |
  17. Buckland, Genevieve |
  18. Sánchez, María José |
  19. Dorronsoro, Miren |
  20. Chirlaque, Maria-Dolores |
  21. Barricarte, Aurelio |
  22. Khaw, Kay-Tee |
  23. Wareham, Nicholas J. |
  24. Bradbury, Kathryn E. |
  25. Trichopoulou, Antonia |
  26. Lagiou, Pagona |
  27. Trichopoulos, Dimitri |
  28. Palli, Domenico |
  29. Krogh, Vittorio |
  30. Tumino, Rosario |
  31. Naccarati, Alessio |
  32. Panico, Salvatore |
  33. Siersema, Peter D. |
  34. Peeters, Petra H.M. |
  35. Ljuslinder, Ingrid |
  36. Johansson, Ingegerd |
  37. Ericson, Ulrika |
  38. Ohlsson, Bodil |
  39. Weiderpass, Elisabete |
  40. Skeie, Guri |
  41. Benjaminsen Borch, Kristin |
  42. Rinaldi, Sabina |
  43. Romieu, Isabelle |
  44. Kong, Joyce |
  45. Gunter, Marc J. |
  46. Ward, Heather A. |
  47. Riboli, Elio |
  48. Boeing, Heiner |
1000 Erscheinungsjahr 2014
1000 LeibnizOpen
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2014-10-10
1000 Erschienen in
1000 Quellenangabe
  • 12: 168
1000 FRL-Sammlung
1000 Copyrightjahr
  • 2014
1000 Lizenz
1000 Verlagsversion
  • http://doi.org/10.1186/s12916-014-0168-4 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4192278/ |
1000 Ergänzendes Material
  • https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0168-4#Sec11 |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • BACKGROUND: 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 <0.0001. The associations were present for both colon and rectal cancers, HRs, 0.61 (95% CI: 0.50 to 0.74; P for trend <0.0001) for colon cancer and 0.68 (95% CI: 0.53 to 0.88; P-trend <0.0001) for rectal cancer, respectively (P-difference by cancer sub-site = 0.10). Overall, 16% of the new CRC cases (22% in men and 11% in women) were attributable to not adhering to a combination of all five healthy lifestyle behaviours included in the index. CONCLUSIONS: Combined lifestyle factors are associated with a lower incidence of CRC in European populations characterized by western lifestyles. Prevention strategies considering complex targeting of multiple lifestyle factors may provide practical means for improved CRC prevention.
1000 Sacherschließung
lokal colorectal cancer
lokal combined impact
lokal lifestyle factors
lokal European Prospective Investigation into Cancer and Nutrition (EPIC)
lokal population attributable risks
1000 Fächerklassifikation (DDC)
1000 Liste der Beteiligten
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1000 Label
1000 Förderer
  1. European Commission (DG-SANCO) |
  2. International Agency for Research on Cancer |
  3. Danish Cancer Society |
  4. Ligue Contre le Cancer |
  5. Institut Gustave Roussy |
  6. Mutuelle Générale de l’Education Nationale |
  7. Institut National de la Santé et de la Recherche Médicale (INSERM) |
  8. Deutsche Krebshilfe |
  9. Deutsches Krebsforschungszentrum |
  10. Federal Ministry of Education and Research (Germany) |
  11. Hellenic Health Foundation |
  12. Italian Association for Research on Cancer (AIRC) |
  13. National Research Council |
  14. HuGeF Foundation |
  15. Compagnia di San Paolo |
  16. Sicily Regional Government |
  17. AIRE ONLUS Ragusa |
  18. AVIS Ragusa |
  19. Dutch Ministry of Public Health, Welfare and Sports (VWS) |
  20. Netherlands Cancer Registry (NKR) |
  21. LK Research Funds |
  22. Dutch Prevention Funds |
  23. Dutch ZON (Zorg Onderzoek Nederland) |
  24. World Cancer Research Fund (WCRF) |
  25. Statistics Netherlands |
  26. ERC |
  27. Nordforsk |
  28. Nordic Centre of Excellence programme on Food, Nutrition and Health |
  29. Norwegian Research Council |
  30. Norwegian Cancer Society |
  31. University of Tromso |
  32. Health Research Fund (FIS) |
  33. Regional Government of Andaluc-a |
  34. Regional Government of Asturias |
  35. Regional Government of Basque Country |
  36. Regional Government of Murcia |
  37. Regional Government of Navarra |
  38. ISCIII RETIC |
  39. Swedish Cancer Society |
  40. Swedish Scientific Council |
  41. Regional Government of Skåne |
  42. Regional Government of Västerbotten |
  43. Cancer Research UK |
  44. Medical Research Council |
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1000 @id frl:6405892.rdf
1000 Erstellt am 2017-12-15T14:31:41.844+0100
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