Changes in Lifestyle and Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition
Edoardo Botteri
(1, 2)
,
Giulia Peveri
(3, 4)
,
Paula Berstad
(2)
,
Vincenzo Bagnardi
(5)
,
Sairah L.F. Chen
(6)
,
Torkjel Sandanger
(6)
,
Geir Hoff
(2)
,
Christina Dahm
(7)
,
Christian Antoniussen
(7)
,
Anne Tjønneland
(8)
,
Anne Kirstine Eriksen
(8)
,
Guri Skeie
(6)
,
Aurora Perez-Cornago
(9, 10)
,
José María Huerta
(11)
,
Paula Jakszyn
(12)
,
Sophia Harlid
(13)
,
Björn Sundström
(13)
,
Aurelio Barricarte
(11, 14, 13)
,
Evelyn Monninkhof
(15, 16)
,
Jeroen W.G. Derksen
(15, 16)
,
Matthias Schulze
(17, 18)
,
Bas Bueno-De-Mesquita
(19)
,
Maria-Jose Sánchez
(11, 20, 21)
,
Amanda Cross
(22)
,
Konstantinos Tsilidis
(22, 23)
,
Maria Santucci de Magistris
(24)
,
Rudolf Kaaks
(25)
,
Verena Katzke
(25)
,
Joseph Rothwell
(26)
,
Nasser Laouali
(26)
,
Gianluca Severi
(26, 27)
,
Pilar Amiano
(11)
,
Paolo Contiero
(28)
,
Carlotta Sacerdote
(29)
,
Marcel Goldberg
(30)
,
Mathilde Touvier
(31, 32)
,
Heinz Freisling
(33)
,
Vivian Viallon
(33)
,
Elisabete Weiderpass
(33)
,
Elio Riboli
(22)
,
Marc Gunter
(33)
,
Mazda Jenab
(33)
,
Pietro Ferrari
(33)
1
Oslo University Hospital [Oslo]
2 Cancer Registry of Norway
3 UNIMI - Università degli Studi di Milano = University of Milan
4 MEB - Department of Medical Epidemiology and Biostatistics
5 UNIMIB - Università degli Studi di Milano-Bicocca = University of Milano-Bicocca
6 UiT - The Arctic University of Norway [Tromsø, Norway]
7 Aarhus University [Aarhus]
8 DCSRC - Danish Cancer Society Research Center [Copenhagen, Denmark]
9 University of Oxford
10 Nuffield Department of Population Health [Oxford]
11 CIBERESP - Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health
12 La Salle [Ramon Llull University]
13 Umeå University = Umeå Universitet
14 IDIBELL - Institut d'Investigació Biomèdica de Bellvitge = Bellvitge Biomedical Research Institute
15 Universiteit Utrecht / Utrecht University [Utrecht]
16 Julius Center for Health Sciences and Primary Care
17 DIfE - German Institute of Human Nutrition Potsdam-Rehbrücke
18 University of Potsdam = Universität Potsdam
19 RIVM - National Institute for Public Health and the Environment [Bilthoven]
20 Granada.ibs - Escuela Andaluza de Salud Publica
21 UGR - Universidad de Granada = University of Granada
22 Imperial College London
23 University of Ioannina
24 University of Naples Federico II = Università degli studi di Napoli Federico II
25 DKFZ - German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg]
26 CESP - Centre de recherche en épidémiologie et santé des populations
27 UniFI - Università degli Studi di Firenze = University of Florence = Université de Florence
28 IRCCS Istituto Nazionale dei Tumori [Milano]
29 Azienda Ospedalerio - Universitaria Città della Salute e della Scienza di Torino = University Hospital Città della Salute e della Scienza di Torino
30 CONSTANCES - Cohortes épidémiologiques en population
31 EREN [CRESS - U1153 / UMR_A 1125] - Nutritional Epidemiology Research Team | Equipe de Recherche en Epidémiologie Nutritionnelle
32 Hôpital Avicenne [AP-HP]
33 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
2 Cancer Registry of Norway
3 UNIMI - Università degli Studi di Milano = University of Milan
4 MEB - Department of Medical Epidemiology and Biostatistics
5 UNIMIB - Università degli Studi di Milano-Bicocca = University of Milano-Bicocca
6 UiT - The Arctic University of Norway [Tromsø, Norway]
7 Aarhus University [Aarhus]
8 DCSRC - Danish Cancer Society Research Center [Copenhagen, Denmark]
9 University of Oxford
10 Nuffield Department of Population Health [Oxford]
11 CIBERESP - Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health
12 La Salle [Ramon Llull University]
13 Umeå University = Umeå Universitet
14 IDIBELL - Institut d'Investigació Biomèdica de Bellvitge = Bellvitge Biomedical Research Institute
15 Universiteit Utrecht / Utrecht University [Utrecht]
16 Julius Center for Health Sciences and Primary Care
17 DIfE - German Institute of Human Nutrition Potsdam-Rehbrücke
18 University of Potsdam = Universität Potsdam
19 RIVM - National Institute for Public Health and the Environment [Bilthoven]
20 Granada.ibs - Escuela Andaluza de Salud Publica
21 UGR - Universidad de Granada = University of Granada
22 Imperial College London
23 University of Ioannina
24 University of Naples Federico II = Università degli studi di Napoli Federico II
25 DKFZ - German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg]
26 CESP - Centre de recherche en épidémiologie et santé des populations
27 UniFI - Università degli Studi di Firenze = University of Florence = Université de Florence
28 IRCCS Istituto Nazionale dei Tumori [Milano]
29 Azienda Ospedalerio - Universitaria Città della Salute e della Scienza di Torino = University Hospital Città della Salute e della Scienza di Torino
30 CONSTANCES - Cohortes épidémiologiques en population
31 EREN [CRESS - U1153 / UMR_A 1125] - Nutritional Epidemiology Research Team | Equipe de Recherche en Epidémiologie Nutritionnelle
32 Hôpital Avicenne [AP-HP]
33 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
Edoardo Botteri
- Fonction : Auteur
- PersonId : 1260521
- ORCID : 0000-0002-9023-8068
Aurelio Barricarte
- Fonction : Auteur
Mathilde Touvier
- Fonction : Auteur
- PersonId : 1136541
Résumé
INTRODUCTION: We investigated the impact of changes in lifestyle habits on colorectal cancer (CRC) risk in a multicountry European cohort. METHODS: We used baseline and follow-up questionnaire data from the European Prospective Investigation into Cancer cohort to assess changes in lifestyle habits and their associations with CRC development. We calculated a healthy lifestyle index (HLI) score based on smoking status, alcohol consumption, body mass index, and physical activity collected at the 2 time points. HLI ranged from 0 (most unfavorable) to 16 (most favorable). We estimated the association between HLI changes and CRC risk using Cox regression models and reported hazard ratios (HR) with 95% confidence intervals (CI). RESULTS: Among 295,865 participants, 2,799 CRC cases were observed over a median of 7.8 years. The median time between questionnaires was 5.7 years. Each unit increase in HLI from the baseline to the follow-up assessment was associated with a statistically significant 3% lower CRC risk. Among participants in the top tertile at baseline (HLI > 11), those in the bottom tertile at follow-up (HLI ≤ 9) had a higher CRC risk (HR 1.34; 95% CI 1.02–1.75) than those remaining in the top tertile. Among individuals in the bottom tertile at baseline, those in the top tertile at follow-up had a lower risk (HR 0.77; 95% CI 0.59–1.00) than those remaining in the bottom tertile. DISCUSSION: Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention.