欧洲癌症与营养前瞻性调查队列研究中的健康生活方式与癌症风险
Healthy Lifestyle and Risk of Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort Study.
作者信息
McKenzie Fiona, Biessy Carine, Ferrari Pietro, Freisling Heinz, Rinaldi Sabina, Chajès Veronique, Dahm Christina C, Overvad Kim, Dossus Laure, Lagiou Pagona, Trichopoulos Dimitrios, Trichopoulou Antonia, Bueno-de-Mesquita H Bas, May Anne, Peeters Petra H, Weiderpass Elisabete, Sanchez Maria-Jose, Navarro Carmen, Ardanaz Eva, Ericson Ulrika, Wirfält Elisabet, Travis Ruth C, Romieu Isabelle
机构信息
From the International Agency for Research on Cancer (IARC), Lyon (FM, CB, PF, HF, SR, VC, IR), INSERM, Centre for Research in Epidemiology and Population Health (CESP) (LD), Paris South University, UMRS 1018 (LD), Department of Public Health, Aarhus University, Aarhus, Denmark (CCD, KO), Institute Gustave Roussy (LD), INSERM, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France (LD), Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School (PL), Bureau of Epidemiologic Research, Academy of Athens (PL, DT), Hellenic Health Foundation, Athens, Greece (DT, AT), Department of Epidemiology, Harvard School of Public Health, Boston, MA (PL, DT), National Institute for Public Health and the Environment (RIVM), Bilthoven (HBBM), Department of Gastroenterology and Hepatology, University Medical Centre (HBBM), Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands (AM, PHP), School of Public Health, Imperial College, London (HBBM, PHP), Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom (RCT), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (HBBM), Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø (EW), Department of Research, Cancer Registry of Norway, Oslo, Norway (EW), Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (EW), Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden (UE, EW), Samfundet Folkhälsan, Helsinki, Finland (EW), CIBER Epidemiology and Public Health (CIBERESP), España (M-JS, CN, EA), Andalusian School of Public Health, University of Granada, Granada (M-JS), Department of Epidemiology, Murcia Regional Health Council (CN), Department of Health and Social Sciences, Universidad de Murcia, Murcia (CN), Navarra Public Health Institute (EA), and Navarra Institute for Health Research (IdiSNA), Pamplona, Spain (EA).
出版信息
Medicine (Baltimore). 2016 Apr;95(16):e2850. doi: 10.1097/MD.0000000000002850.
It has been estimated that at least a third of the most common cancers are related to lifestyle and as such are preventable. Key modifiable lifestyle factors have been individually associated with cancer risk; however, less is known about the combined effects of these factors. This study generated a healthy lifestyle index score (HLIS) to investigate the joint effect of modifiable factors on the risk of overall cancers, alcohol-related cancers, tobacco-related cancers, obesity-related cancers, and reproductive-related cancers. The study included 391,608 men and women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The HLIS was constructed from 5 factors assessed at baseline (diet, physical activity, smoking, alcohol consumption, and anthropometry) by assigning scores of 0 to 4 to categories of each factor, for which higher values indicate healthier behaviors. Hazard ratios (HR) were estimated by Cox proportional regression and population attributable fractions (PAFs) estimated from the adjusted models. There was a 5% lower risk (adjusted HR 0.952, 95% confidence interval (CI): 0.946, 0.958) of all cancers per point score of the index for men and 4% (adjusted HR 0.961, 95% CI: 0.956, 0.966) for women. The fourth versus the second category of the HLIS was associated with a 28% and 24% lower risk for men and women respectively across all cancers, 41% and 33% for alcohol-related, 49% and 46% for tobacco-related, 41% and 26% for obesity-related, and 21% for female reproductive cancers. Findings suggest simple behavior modifications could have a sizeable impact on cancer prevention, especially for men.
据估计，至少三分之一的常见癌症与生活方式有关，因此是可预防的。关键的可改变生活方式因素已分别与癌症风险相关联；然而，对于这些因素的综合影响了解较少。本研究生成了一个健康生活方式指数得分（HLIS），以调查可改变因素对总体癌症、酒精相关癌症、烟草相关癌症、肥胖相关癌症和生殖相关癌症风险的联合影响。该研究纳入了来自多国欧洲癌症与营养前瞻性调查（EPIC）队列的391,608名男性和女性。HLIS由基线时评估的5个因素（饮食、身体活动、吸烟、饮酒和人体测量学）构建，通过为每个因素的类别分配0至4分，分数越高表明行为越健康。通过Cox比例回归估计风险比（HR），并从调整模型中估计人群归因分数（PAF）。该指数每增加一分，男性患所有癌症的风险降低5%（调整后HR 0.952，95%置信区间（CI）：0.946，0.958），女性降低4%（调整后HR 0.961，95%CI：0.956，0.966）。在所有癌症中，HLIS的第四类与第二类相比，男性和女性的风险分别降低28%和24%，酒精相关癌症降低41%和33%，烟草相关癌症降低49%和46%，肥胖相关癌症降低41%和26%，女性生殖癌症降低21%。研究结果表明，简单的行为改变可能对癌症预防产生重大影响，尤其是对男性。
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