European journal of cancer (Oxford, England : 1990) · 2026
Association between lifestyle and risk of early-onset cancer: Evidence from the European Prospective Investigation into Cancer and Nutrition and the UK Biobank.
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Sala Isabella, Botteri Edoardo, Berstad Paula, Fontvieille Emma, Zouiouich Semi, Sánchez Maria-José, Guevara Marcela, Dorronsoro Ane, Olsen Anja, Kyrø Cecilie, Zamora-Ros Raul, Fortner Renée Turzanski, Kaaks Rudolf, Schulze Matthias B, Tin Sandar Tin, Agnoli Claudia, Masala Giovanna, Panico Salvatore, Ricceri Fulvio, Severi Gianluca, Marques Chloé, Bouteille Léa, Aune Dagfinn, Weiderpass Elisabete, Jenab Mazda, Cross Amanda J, Tsilidis Kostas, Vineis Paolo, Gunter Marc J, Ferrari Pietro, Bagnardi Vincenzo
Аннотация
BACKGROUND: The incidence of early-onset cancers (EOCs), defined as cancers diagnosed before 50 years of age, has risen globally over the past three decades. The association between modifiable lifestyle factors and EOC risk has been poorly investigated.
METHODS: Participants enrolled before age 50 in EPIC (39,459 men; 110,991 women) and the UK Biobank (52,188 men; 62,528 women) were analysed. We examined the association between smoking, alcohol consumption, body mass index (BMI), physical activity and diet, and risk of lifestyle-related EOCs - including cancer of the breast, lung, colorectum, stomach, liver, cervix, oesophagus, bladder, and others. Each risk factor was scored from 0 (most unfavourable) to 4 (most favourable). Cohort-specific hazard ratios (HR) with 95% confidence intervals (CI) were estimated in Cox regression models and pooled via a meta-analytic approach.
FINDINGS: We observed 361 lifestyle-related EOCs in men and 2618 in women, including 1765 breast cancers. In men, one-point increase in the smoking score, indicating less smoking, was inversely associated with risk of lifestyle-related EOC (HR 0.82, 95% CI: 0.76-0.88). In women, each one-point increase in smoking (less smoking), BMI (lower BMI), and physical activity (more active) scores was inversely associated with risk of lifestyle-related EOC excluding breast cancer (HRs: 0.89 [0.84-0.93], 0.93 [0.89-0.98], 0.95 [0.90-1.00], respectively). For breast cancer, only physical activity showed a statistically significant association (HR 0.95 [0.91-0.995]). Alcohol and diet showed no association.
INTERPRETATION: These findings support the importance of adopting a healthy lifestyle early in life to reduce cancer risk before the age of 50.
METHODS: Participants enrolled before age 50 in EPIC (39,459 men; 110,991 women) and the UK Biobank (52,188 men; 62,528 women) were analysed. We examined the association between smoking, alcohol consumption, body mass index (BMI), physical activity and diet, and risk of lifestyle-related EOCs - including cancer of the breast, lung, colorectum, stomach, liver, cervix, oesophagus, bladder, and others. Each risk factor was scored from 0 (most unfavourable) to 4 (most favourable). Cohort-specific hazard ratios (HR) with 95% confidence intervals (CI) were estimated in Cox regression models and pooled via a meta-analytic approach.
FINDINGS: We observed 361 lifestyle-related EOCs in men and 2618 in women, including 1765 breast cancers. In men, one-point increase in the smoking score, indicating less smoking, was inversely associated with risk of lifestyle-related EOC (HR 0.82, 95% CI: 0.76-0.88). In women, each one-point increase in smoking (less smoking), BMI (lower BMI), and physical activity (more active) scores was inversely associated with risk of lifestyle-related EOC excluding breast cancer (HRs: 0.89 [0.84-0.93], 0.93 [0.89-0.98], 0.95 [0.90-1.00], respectively). For breast cancer, only physical activity showed a statistically significant association (HR 0.95 [0.91-0.995]). Alcohol and diet showed no association.
INTERPRETATION: These findings support the importance of adopting a healthy lifestyle early in life to reduce cancer risk before the age of 50.