Arthur Rhonda, Kirsh Victoria A, Kreiger Nancy, Rohan Thomas
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA.
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Cancer Causes Control. 2018 Jun;29(6):485-493. doi: 10.1007/s10552-018-1032-1. Epub 2018 Apr 17.
Several modifiable risk factors have been associated with risk of female cancers, but there is limited data regarding their combined effect on risk among Canadian women. Therefore, we assessed the joint association of modifiable risk factors, using a healthy lifestyle index (HLI) score, with risk of specific reproductive cancers.
This study included a subcohort of 3,185 of the 39,618 women, who participated in the Canadian Study of Diet, Lifestyle, and Health, and in whom 410, 177, and 100 postmenopausal breast, endometrial, and ovarian cancers, respectively, were ascertained. We estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards regression models modified for the case-cohort design.
Each unit increase in the HLI score was associated with 3% and 5% reductions in risk of postmenopausal breast cancer and endometrial cancer, respectively (HR 0.97; 95% CI 0.94-0.99 and HR 0.95; 95% CI 0.90-0.99, respectively). Compared to those with HLI score in the lowest category, those in the highest category had 30% and 46% reductions in risk of these cancers, respectively. The HLI score was not associated with altered risk of ovarian cancer.
Our findings suggest that promoting a healthy lifestyle may aid in the primary prevention of postmenopausal breast and endometrial cancers.
多种可改变的风险因素与女性癌症风险相关,但关于它们对加拿大女性风险的综合影响的数据有限。因此,我们使用健康生活方式指数(HLI)评分评估了可改变风险因素与特定生殖系统癌症风险的联合关联。
本研究纳入了参与加拿大饮食、生活方式和健康研究的39618名女性中的3185名组成的一个亚队列,在这些女性中分别确诊了410例绝经后乳腺癌、177例子宫内膜癌和100例卵巢癌。我们使用针对病例队列设计修改的Cox比例风险回归模型估计风险比(HR)和95%置信区间(CI)。
HLI评分每增加一个单位,绝经后乳腺癌和子宫内膜癌的风险分别降低3%和5%(HR分别为0.97;95%CI为0.94 - 0.99和HR为0.95;95%CI为0.90 - 0.99)。与HLI评分处于最低类别的女性相比,处于最高类别的女性患这些癌症的风险分别降低了30%和46%。HLI评分与卵巢癌风险的改变无关。
我们的研究结果表明,促进健康的生活方式可能有助于绝经后乳腺癌和子宫内膜癌的一级预防。