Department of Epidemiology, Faculty of Medicine and Pharmacy, Fez, Morocco; University of Lyon, UCBL, Ifsttar, UMRESTTE, Lyon, France; Department of Community Health and Social Medicine, City University of New York, School of Medicine, NY, USA.
Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
Cancer Epidemiol. 2019 Feb;58:160-166. doi: 10.1016/j.canep.2018.12.012. Epub 2018 Dec 29.
Some modifiable risk factors have been independently associated with breast cancer (BC) risk in Moroccan women, but no studies have investigated their joint association. This study aimed to investigate the association between a Healthy Lifestyle Index (HLI) score and BC risk among Moroccan women.
In this case-control study, 300 incident BC cases and 300 controls, matched by age and area of residence were recruited. Cases were women newly-diagnosed with histopathologically-confirmed BC at the University Hospital in Fez, Morocco. Controls were randomly selected healthy women recruited from 6 primary health centers in Fez. HLI scores developed within this study were assigned to participants based on 11 factors (red and processed meat, white meat, cream, cheese, fish, fruit and vegetables, physical activity, BMI, smoking, alcohol consumption, and breastfeeding), where 0 was given to unhealthy and 0.5 or 1 to healthy levels of each factor. Conditional and unconditional logistic regression models were used to assess the association between HLI scores and BC risk.
Mean of HLI scores were 8.1 (±1.1) and 9.0 (±0.9) in cases and controls, respectively, p < 0.01. After adjusting for potential confounders, one-point increment in the HLI score was associated with 56% (95% CI, CI: 39-68%), 49% (95% CI: 30-63%), and 59% (95% CI: 40-72%) lower risks of BC in all, premenopausal, and postmenopausal women, respectively.
High HLI scores were associated with decreased risk of BC in Moroccan women. These findings suggest that BC prevention policies should include strategies for engaging Moroccan women in healthy lifestyles.
一些可改变的风险因素已被独立证实与摩洛哥女性的乳腺癌（BC）风险相关，但尚无研究调查它们的联合关联。本研究旨在调查摩洛哥女性健康生活方式指数（HLI）评分与 BC 风险之间的关联。
在这项病例对照研究中，招募了 300 名新确诊的经组织病理学证实的 BC 病例和 300 名匹配年龄和居住区域的对照。病例是在摩洛哥非斯大学医院新诊断为组织病理学确诊的 BC 女性。对照是从非斯的 6 个初级保健中心随机选择的健康女性。根据 11 个因素（红色和加工肉类、白色肉类、奶油、奶酪、鱼类、水果和蔬菜、身体活动、BMI、吸烟、饮酒和母乳喂养）制定了本研究中的 HLI 评分，并为参与者分配 0 分表示不健康，0.5 分或 1 分表示每个因素的健康水平。使用条件和非条件逻辑回归模型评估 HLI 评分与 BC 风险之间的关联。
病例和对照的 HLI 评分平均值分别为 8.1（±1.1）和 9.0（±0.9），p<0.01。在调整潜在混杂因素后，HLI 评分每增加 1 分，所有女性、绝经前和绝经后女性的 BC 风险分别降低 56%（95%CI：39-68%）、49%（95%CI：30-63%）和 59%（95%CI：40-72%）。
高 HLI 评分与摩洛哥女性的 BC 风险降低相关。这些发现表明，BC 预防政策应包括让摩洛哥女性参与健康生活方式的策略。
