Lifestyle changes in middle age and risk of cancer: evidence from the European Prospective Investigation into Cancer and Nutrition.
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Botteri Edoardo, Peveri Giulia, Berstad Paula, Bagnardi Vincenzo, Hoff Geir, Heath Alicia K, Cross Amanda J, Vineis Paolo, Dossus Laure, Johansson Mattias, Freisling Heinz, Matta Komodo, Huybrechts Inge, Chen Sairah L F, B Borch Kristin, Sandanger Torkjel M, H Nøst Therese, Dahm Christina C, Antoniussen Christian S, Tin Tin Sandar, Fournier Agnès, Marques Chloé, Artaud Fanny, Sánchez Maria-José, Guevara Marcela, Santiuste Carmen, Agudo Antonio, Bajracharya Rashmita, Katzke Verena, Ricceri Fulvio, Agnoli Claudia, Bergmann Manuela M, Schulze Matthias B, Panico Salvatore, Masala Giovanna, Tjønneland Anne, Olsen Anja, Stocks Tanja, Manjer Jonas, Aizpurua-Atxega Amaia, Weiderpass Elisabete, Riboli Elio, Gunter Marc J, Ferrari Pietro
Аннотация
In this study, we aimed to provide novel evidence on the impact of changing lifestyle habits on cancer risk. In the EPIC cohort, 295,865 middle-aged participants returned a lifestyle questionnaire at baseline and during follow-up. At both timepoints, we calculated a healthy lifestyle index (HLI) score based on cigarette smoking, alcohol consumption, body mass index and physical activity. HLI ranged from 0 (most unfavourable) to 16 (most favourable). We estimated the association between HLI change and risk of lifestyle-related cancers-including cancer of the breast, lung, colorectum, stomach, liver, cervix, oesophagus, bladder, and others-using Cox regression models. We reported hazard ratios (HR) with 95% confidence intervals (CI). Median time between the two questionnaires was 5.7 years, median age at follow-up questionnaire was 59 years. After the follow-up questionnaire, we observed 14,933 lifestyle-related cancers over a median follow-up of 7.8 years. Each unit increase in the HLI score was associated with 4% lower risk of lifestyle-related cancers (HR 0.96; 95%CI 0.95-0.97). Among participants in the top HLI third at baseline (HLI > 11), those in the bottom third at follow-up (HLI ≤ 9) had 21% higher risk of lifestyle-related cancers (HR 1.21; 95%CI 1.07-1.37) than those remaining in the top third. Among participants in the bottom HLI third at baseline, those in the top third at follow-up had 25% lower risk of lifestyle-related cancers (HR 0.75; 95%CI 0.65-0.86) than those remaining in the bottom third. These results indicate that lifestyle changes in middle age may have a significant impact on cancer risk.