Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003, Girona, Spain; Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, 17004, Girona, Spain.
Balearic Islands Health Research Institute (IdISBa), University Hospital Son Espases, 07120, Palma de Mallorca, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain; ISGlobal, 08003, Barcelona, Spain.
Cancer Epidemiol. 2020 Feb;64:101629. doi: 10.1016/j.canep.2019.101629. Epub 2019 Nov 19.
Preventable risk factors for chronic lymphocytic leukemia (CLL) remain largely unknown. The aim of this study was to evaluate the association between adherence to nutrition-based guidelines for cancer prevention and CLL, in the MCC-Spain case-control study.
A total of 318 CLL cases and 1293 population-based controls were included in the present study. The World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) score based on the 2018 recommendations for cancer prevention (on body fatness, physical activity, and diet) was constructed. We used logistic regression analysis adjusting for potential confounders.
Individuals in the highest tertile of the WCRF/AICR score had an odds ratio for CLL of 1.25 (95 % CI 0.91; 1.73) compared with individuals with low adherence (p-trend = 0.172). Each point increment in the score was associated with an OR for CLL of 1.06 (95 % CI 0.91; 1.23). Analyses by severity of disease did not show significant heterogeneity of effects.
Overall, our results do not support an association between the WCRF/AICR score and CLL, yet we might have been limited by statistical power and study design to detect modest associations. Further research, ideally with a prospective design, long follow-up, and including additional lymphoma subtypes, is warranted to confirm the impact of composite healthy lifestyle behaviors on lymphoma risk.
慢性淋巴细胞白血病（CLL）的可预防风险因素在很大程度上仍不清楚。本研究旨在评估预防癌症的营养指南依从性与 CLL 之间的关联，该研究基于 MCC-Spain 病例对照研究。
本研究共纳入 318 例 CLL 病例和 1293 名基于人群的对照。根据 2018 年预防癌症（关于体脂、身体活动和饮食）的建议构建了基于世界癌症研究基金会/美国癌症研究所（WCRC/AICR）评分的分数。我们使用调整了潜在混杂因素的逻辑回归分析。
与低依从性者相比，WCRF/AICR 评分最高三分位者患 CLL 的比值比为 1.25（95%CI 0.91；1.73）（p 趋势=0.172）。评分每增加 1 分，患 CLL 的比值比为 1.06（95%CI 0.91；1.23）。按疾病严重程度进行分析，并未显示出效果存在显著异质性。
总体而言，我们的结果不支持 WCRF/AICR 评分与 CLL 之间存在关联，但我们可能受到统计能力和研究设计的限制，无法检测到适度的关联。需要进一步的研究，理想情况下是前瞻性设计、长期随访，并包括其他淋巴瘤亚型，以确认综合健康生活方式行为对淋巴瘤风险的影响。
