Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen Ø, Denmark.
BMJ. 2010 Oct 26;341:c5504. doi: 10.1136/bmj.c5504.
To evaluate the association between a simple lifestyle index based on the recommendations for five lifestyle factors and the incidence of colorectal cancer, and to estimate the proportion of colorectal cancer cases attributable to lack of adherence to the recommendations.
Prospective cohort study.
General population of Copenhagen and Aarhus, Denmark.
55 487 men and women aged 50-64 years at baseline (1993-7), not previously diagnosed with cancer.
Risk of colorectal cancer in relation to points achieved in the lifestyle index (based on physical activity, waist circumference, smoking, alcohol intake, and diet (dietary fibre, energy percentage from fat, red and processed meat, and fruits and vegetables)) modelled through Cox regression.
During a median follow-up of 9.9 years, 678 men and women had colorectal cancer diagnosed. After adjustment for potential confounders, each additional point achieved on the lifestyle index, corresponding to one additional recommendation that was met, was associated with a lower risk of colorectal cancer (incidence rate ratio 0.89 (95% confidence interval 0.82 to 0.96). In this population an estimated total of 13% (95% CI 4% to 22%) of the colorectal cancer cases were attributable to lack of adherence to merely one additional recommendation among all participants except the healthiest. If all participants had followed the five recommendations 23% (9% to 37%) of the colorectal cancer cases might have been prevented. Results were similar for colon and rectal cancer, but only statistically significant for colon cancer.
Adherence to the recommendations for physical activity, waist circumference, smoking, alcohol intake, and diet may reduce colorectal cancer risk considerably, and in this population 23% of the cases might be attributable to lack of adherence to the five lifestyle recommendations. The simple structure of the lifestyle index facilitates its use in public health practice.
评估基于 5 种生活方式因素建议的简单生活方式指数与结直肠癌发病率之间的关联，并估计因不遵守建议而导致的结直肠癌病例比例。
前瞻性队列研究。
丹麦哥本哈根和奥胡斯的一般人群。
55487 名年龄在 50-64 岁之间的基线时（1993-7 年）未被诊断患有癌症的男性和女性。
通过 Cox 回归模型，根据生活方式指数（基于体力活动、腰围、吸烟、饮酒和饮食（膳食纤维、脂肪能量百分比、红色和加工肉类以及水果和蔬菜））获得的分数与结直肠癌风险之间的关系。
在中位随访 9.9 年期间，678 名男性和女性被诊断患有结直肠癌。在调整潜在混杂因素后，生活方式指数每增加一个点，相当于满足了一个额外的建议，与结直肠癌风险降低相关（发病率比 0.89（95%置信区间 0.82 至 0.96）。在该人群中，估计总共有 13%（95%置信区间 4%至 22%）的结直肠癌病例归因于除最健康者以外的所有参与者中缺乏遵守仅仅一项额外建议。如果所有参与者都遵循了这 5 项建议，那么可能会预防 23%（9%至 37%）的结直肠癌病例。这些结果在结肠癌和直肠癌中相似，但仅在结肠癌中具有统计学意义。
遵守体力活动、腰围、吸烟、饮酒和饮食的建议可能会大大降低结直肠癌的风险，在该人群中，23%的病例可能归因于不遵守 5 项生活方式建议。生活方式指数的简单结构使其易于在公共卫生实践中使用。
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