Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
Division of Cancer Prevention and Control, Department of Internal Medicine, Ohio State University College of Medicine, Columbus, Ohio.
Am J Epidemiol. 2019 Feb 1;188(2):261-273. doi: 10.1093/aje/kwy249.
Lifestyle-related factors influence risk of endometrial and ovarian cancers, but few studies have examined their joint associations with risk of these cancers. Using multivariable Cox regression models, we assessed the association of a healthy lifestyle index (HLI-a composite score (range, 0-20) involving diet, alcohol consumption, physical activity, body mass index, and smoking; higher scores represent healthier behavior) with risk of endometrial and ovarian cancers among 108,136 postmenopausal women who were recruited in the US Women's Health Initiative study between 1993 and 1998. After a median follow-up of 17.9 years, 1,435 endometrial cancer cases and 904 ovarian cancer cases had been ascertained. Women in the highest quintile of the HLI score had a lower risk of overall, type I, well-differentiated, moderately differentiated, poorly differentiated, and localized endometrial cancer than those in the lowest quintile (for quintile 5 vs. quintile 1, hazard ratio (HR) = 0.61 (95% CI: 0.51, 0.72), HR = 0.60 (95% CI: 0.49, 0.72), HR = 0.66 (95% CI: 0.46, 0.96), HR = 0.69 (95% CI: 0.52, 0.90), HR = 0.49 (95% CI: 0.34, 0.72), and HR = 0.61 (95% CI: 0.50, 0.74), respectively). The HLI score had a weak positive association with risk of serous ovarian cancer. Our findings underscore the potential importance of a healthy lifestyle in lowering endometrial cancer risk among postmenopausal women.
生活方式相关因素会影响子宫内膜癌和卵巢癌的风险，但很少有研究探讨这些因素与这些癌症风险的联合关联。我们使用多变量 Cox 回归模型，评估了健康生活方式指数（HLI-一种涉及饮食、饮酒、身体活动、体重指数和吸烟的复合评分（范围 0-20 分；得分越高表示行为越健康））与 1993 年至 1998 年期间在美国妇女健康倡议研究中招募的 108136 名绝经后妇女的子宫内膜癌和卵巢癌风险之间的关系。中位随访 17.9 年后，共确定了 1435 例子宫内膜癌病例和 904 例卵巢癌病例。HLI 评分最高五分位的女性患所有、I 型、高分化、中分化、低分化和局部子宫内膜癌的风险低于最低五分位的女性（五分位 5 比五分位 1，风险比（HR）=0.61（95%CI：0.51，0.72），HR=0.60（95%CI：0.49，0.72），HR=0.66（95%CI：0.46，0.96），HR=0.69（95%CI：0.52，0.90），HR=0.49（95%CI：0.34，0.72），HR=0.61（95%CI：0.50，0.74））。HLI 评分与浆液性卵巢癌风险呈弱正相关。我们的研究结果强调了健康生活方式在降低绝经后妇女子宫内膜癌风险方面的潜在重要性。
