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健康生活与癌症:来自英国生物银行的证据。

Healthy living and cancer: evidence from UK Biobank.

作者信息

Elwood Peter C, Whitmarsh Alex, Gallacher John, Bayer Anthony, Adams Richard, Heslop Luke, Pickering Janet, Morgan Gareth, Galante Julieta, Dolwani Sunil, Longley Marcus, Roberts Zoe E

机构信息

Division of Population Medicine, Cardiff University, Cardiff CF10 3AT, UK.

Dementia Platform, Department of Psychiatry, University of Oxford, Oxford OX1 2JD, UK.

出版信息

Ecancermedicalscience. 2018 Jan 4;12:792. doi: 10.3332/ecancer.2018.792. eCollection 2018.

Abstract

CONTEXT

UK Biobank is a prospective study of half a million subjects, almost all aged 40-69 years, identified in 22 centres across the UK during 2006-2010.

OBJECTIVE

A healthy lifestyle has been described as 'better than any pill, and no side effects [5]. We therefore examined the relationships between healthy behaviours: low alcohol intake, non-smoking, healthy BMI, physical activity and a healthy diet, and the risk of all cancers, colon, breast and prostate cancers in a large dataset.

METHOD

Data on lifestyle behaviours were provided by 343,150 subjects, and height and weight were measured at recruitment. 14,285 subjects were diagnosed with cancer during a median of 5.1 years of follow-up.

RESULTS

Compared with subjects who followed none or a single healthy behaviour, a healthy lifestyle based on all five behaviours was associated with a reduction of about one-third in incident cancer (hazard ratio [HR] 0.68; 95% confidence intervals [CI] 0.63-0.74). Colorectal cancer was reduced in subjects following the five behaviours by about one-quarter (HR 0.75; 95% CI 0.58-0.97), and breast cancer by about one-third (HR 0.65; 95% CI 0.52-0.83). The association between a healthy lifestyle and prostate cancer suggested a significant increase in risk, but this can be attributed to bias consequent on inequalities in the uptake of the prostate specific antigen screening test.

CONCLUSIONS

Taken together with reported reductions in diabetes, vascular disease and dementia, it is clearly important that every effort is taken to promote healthy lifestyles throughout the population, and it is pointed out that cancer and other screening clinics afford 'teachable moments' for the promotion of a healthy lifestyle.

摘要

背景

英国生物银行是一项针对50万受试者的前瞻性研究,这些受试者几乎都年龄在40 - 69岁之间,于2006年至2010年期间在英国各地的22个中心招募。

目的

健康的生活方式被描述为“比任何药物都好,且无副作用”[5]。因此,我们在一个大型数据集中研究了健康行为(低酒精摄入、不吸烟、健康的体重指数、体育活动和健康饮食)与所有癌症、结肠癌、乳腺癌和前列腺癌风险之间的关系。

方法

343,150名受试者提供了生活方式行为数据,招募时测量了身高和体重。在中位随访5.1年期间,14,285名受试者被诊断患有癌症。

结果

与未遵循任何健康行为或仅遵循一种健康行为的受试者相比,基于所有五种行为的健康生活方式与癌症发病率降低约三分之一相关(风险比[HR] 0.68;95%置信区间[CI] 0.63 - 0.74)。遵循这五种行为的受试者中,结直肠癌发病率降低约四分之一(HR 0.75;95% CI 0.58 - 0.97),乳腺癌发病率降低约三分之一(HR 0.65;95% CI 0.52 - 0.83)。健康生活方式与前列腺癌之间的关联表明风险显著增加,但这可归因于前列腺特异性抗原筛查试验采用不平等导致的偏差。

结论

结合已报道的糖尿病、血管疾病和痴呆症发病率的降低,显然必须尽一切努力在整个人口中推广健康的生活方式,并且指出癌症和其他筛查诊所为推广健康生活方式提供了“可教育时机”。

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