Diabetes and Cardiovascular Disease - Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden.
Nutritional Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden.
Int J Cancer. 2020 Mar 1;146(5):1198-1207. doi: 10.1002/ijc.32397. Epub 2019 May 21.
The extent to which a favorable lifestyle may lower cancer risk in subjects with a family history of cancer is unknown. We conducted a prospective study in two Swedish cohorts, the Malmö Diet and Cancer Study (MDCS; n = 25,604) and the Malmö Preventive Project (MPP; n = 16,216). The association between a favorable lifestyle (based on nonsmoking, normal weight, absence of excessive drinking, regular physical activity and healthy diet) and cancer incidence and mortality risk was assessed using Cox regression stratified by family history of cancer (all types). A favorable lifestyle was associated with a 22% (95% confidence interval [CI]: 18-26%) and 40% (95% CI: 36-44%) lower risk of cancer incidence and mortality, respectively, compared to an unfavorable lifestyle. No significant effect modification by family history was observed but there was a null association between lifestyle and cancer incidence among subjects with two or more affected first-degree relatives. The observed relative risk estimates comparing an unfavorable with a favorable lifestyle corresponded to standardized 10-year cancer incidence rates of 11.2 vs. 9.5% in the MDCS, and 4.4 vs. 3.2% in the MPP, and a reduction in 20-year cancer mortality rate from 11.7% to 7.4% in the MDCS and 6.7% to 3.9% in the MPP. Improved adherence to cancer prevention recommendations may reduce cancer incidence and mortality risk in the general population, however, further studies are needed to assess the impact of lifestyle on cancer incidence among subjects with strong familial or polygenic risk for specific cancers.
生活方式的改善在多大程度上可以降低有癌症家族史的个体的癌症风险尚不清楚。我们在两个瑞典队列中进行了一项前瞻性研究，即马尔默饮食与癌症研究（MDCS；n=25604）和马尔默预防项目（MPP；n=16216）。使用 Cox 回归分层分析了生活方式（基于不吸烟、正常体重、不酗酒、经常进行身体活动和健康饮食）与癌症发病率和死亡率风险之间的关联，并根据癌症家族史（所有类型）进行了分层。与不良生活方式相比，良好的生活方式与癌症发病率分别降低了 22%（95%置信区间[CI]：18-26%）和 40%（95% CI：36-44%），与死亡率分别降低了 22%（95%置信区间[CI]：18-26%）和 40%（95% CI：36-44%）。未观察到家族史的显著修饰作用，但在有两个或更多一级亲属受影响的受试者中，生活方式与癌症发病率之间没有关联。与不良生活方式相比，观察到的相对风险估计值分别对应于 MDCS 中 10 年标准化癌症发病率从 11.2%降至 9.5%，MPP 中从 4.4%降至 3.2%，MDCS 中 20 年癌症死亡率从 11.7%降至 7.4%，MPP 中从 6.7%降至 3.9%。改善对癌症预防建议的依从性可能会降低普通人群的癌症发病率和死亡率风险，但是需要进一步研究来评估生活方式对具有特定癌症强烈家族或多基因风险的受试者癌症发病率的影响。
