Prudence R Carr1, Korbinian Weigl2, Lina Jansen3, Viola Walter3, Vanessa Erben4, Jenny Chang-Claude5, Hermann Brenner6, Michael Hoffmeister3. 1. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. Electronic address: p.carr@dkfz.de. 2. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany. 3. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. 4. Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany. 5. Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany; Genetic Tumour Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg, Hamburg, Germany. 6. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany.
Abstract
BACKGROUND & AIMS: The combined effects of healthy lifestyle factors on colorectal cancer (CRC) risk are unclear. We aimed to develop a healthy lifestyle score, to investigate the joint effects of modifiable lifestyle factors on reduction of CRC risk and determine whether associations differ with genetic risk. METHODS: We collected data from a large population-based case-control study in Germany and used multiple logistic regression analyses to examine associations between the healthy lifestyle score (derived from 5 modifiable lifestyle factors: smoking, alcohol consumption, diet, physical activity, and body fatness) and CRC risk. We created a genetic risk score, based on 53 risk variants, to investigate the association of the healthy lifestyle score and risk of CRC, stratified by genetic risk. RESULTS: We included 4092 patients with CRC and 3032 individuals without CRC (controls) in our analysis. In adjusted models, compared with participants with 0 or 1 healthy lifestyle factor, participants with 2 (odds ratio [OR] 0.85; 95% confidence interval [CI] 0.67-1.06), 3 (OR 0.62; 95% CI 0.50-0.77), 4 (OR 0.53; 95% CI 0.42-0.66), or 5 (OR 0.33; 95% CI 0.26-0.43) healthy lifestyle factors had increasingly lower risks of CRC (P trend <.0001). We found no differences among subgroups stratified by genetic risk score, history of colonoscopy, or family history of CRC. Overall, 45% of CRC cases (95% CI 34%-53%) could be attributed to nonadherence to all 5 healthy lifestyle behaviors. CONCLUSIONS: In a large population-based case-control study, we identified a combination of lifestyle factors that appears to reduce risk of CRC, regardless of the patient's genetic profile. These results reinforce the importance of primary prevention of CRC.
BACKGROUND & AIMS: The combined effects of healthy lifestyle factors on colorectal cancer (CRC) risk are unclear. We aimed to develop a healthy lifestyle score, to investigate the joint effects of modifiable lifestyle factors on reduction of CRC risk and determine whether associations differ with genetic risk. METHODS: We collected data from a large population-based case-control study in Germany and used multiple logistic regression analyses to examine associations between the healthy lifestyle score (derived from 5 modifiable lifestyle factors: smoking, alcohol consumption, diet, physical activity, and body fatness) and CRC risk. We created a genetic risk score, based on 53 risk variants, to investigate the association of the healthy lifestyle score and risk of CRC, stratified by genetic risk. RESULTS: We included 4092 patients with CRC and 3032 individuals without CRC (controls) in our analysis. In adjusted models, compared with participants with 0 or 1 healthy lifestyle factor, participants with 2 (odds ratio [OR] 0.85; 95% confidence interval [CI] 0.67-1.06), 3 (OR 0.62; 95% CI 0.50-0.77), 4 (OR 0.53; 95% CI 0.42-0.66), or 5 (OR 0.33; 95% CI 0.26-0.43) healthy lifestyle factors had increasingly lower risks of CRC (P trend <.0001). We found no differences among subgroups stratified by genetic risk score, history of colonoscopy, or family history of CRC. Overall, 45% of CRC cases (95% CI 34%-53%) could be attributed to nonadherence to all 5 healthy lifestyle behaviors. CONCLUSIONS: In a large population-based case-control study, we identified a combination of lifestyle factors that appears to reduce risk of CRC, regardless of the patient's genetic profile. These results reinforce the importance of primary prevention of CRC.
Authors: Dora Romaguera; Anne-Claire Vergnaud; Petra H Peeters; Carla H van Gils; Doris S M Chan; Pietro Ferrari; Isabelle Romieu; Mazda Jenab; Nadia Slimani; Françoise Clavel-Chapelon; Guy Fagherazzi; Florence Perquier; Rudolf Kaaks; Birgit Teucher; Heiner Boeing; Anne von Rüsten; Anne Tjønneland; Anja Olsen; Christina C Dahm; Kim Overvad; José Ramón Quirós; Carlos A Gonzalez; María José Sánchez; Carmen Navarro; Aurelio Barricarte; Miren Dorronsoro; Kay-Tee Khaw; Nicholas J Wareham; Francesca L Crowe; Timothy J Key; Antonia Trichopoulou; Pagona Lagiou; Christina Bamia; Giovanna Masala; Paolo Vineis; Rosario Tumino; Sabina Sieri; Salvatore Panico; Anne M May; H Bas Bueno-de-Mesquita; Frederike L Büchner; Elisabet Wirfält; Jonas Manjer; Ingegerd Johansson; Göran Hallmans; Guri Skeie; Kristin Benjaminsen Borch; Christine L Parr; Elio Riboli; Teresa Norat Journal: Am J Clin Nutr Date: 2012-05-16 Impact factor: 7.045
Authors: Kelvin K F Tsoi; Carol Y Y Pau; William K K Wu; Francis K L Chan; Sian Griffiths; Joseph J Y Sung Journal: Clin Gastroenterol Hepatol Date: 2009-02-24 Impact factor: 11.382
Authors: V Bagnardi; M Rota; E Botteri; I Tramacere; F Islami; V Fedirko; L Scotti; M Jenab; F Turati; E Pasquali; C Pelucchi; C Galeone; R Bellocco; E Negri; G Corrao; P Boffetta; C La Vecchia Journal: Br J Cancer Date: 2014-11-25 Impact factor: 7.640
Authors: Alexi N Archambault; Jihyoun Jeon; Yi Lin; Minta Thomas; Tabitha A Harrison; D Timothy Bishop; Hermann Brenner; Graham Casey; Andrew T Chan; Jenny Chang-Claude; Jane C Figueiredo; Steven Gallinger; Stephen B Gruber; Marc J Gunter; Feng Guo; Michael Hoffmeister; Mark A Jenkins; Temitope O Keku; Loïc Le Marchand; Li Li; Victor Moreno; Polly A Newcomb; Rish Pai; Patrick S Parfrey; Gad Rennert; Lori C Sakoda; Jeffrey K Lee; Martha L Slattery; Mingyang Song; Aung Ko Win; Michael O Woods; Neil Murphy; Peter T Campbell; Yu-Ru Su; Iris Lansdorp-Vogelaar; Elisabeth F P Peterse; Yin Cao; Anne Zeleniuch-Jacquotte; Peter S Liang; Mengmeng Du; Douglas A Corley; Li Hsu; Ulrike Peters; Richard B Hayes Journal: J Natl Cancer Inst Date: 2022-04-11 Impact factor: 11.816
Authors: Timo Bund; Ekaterina Nikitina; Deblina Chakraborty; Claudia Ernst; Karin Gunst; Boyana Boneva; Claudia Tessmer; Nadine Volk; Alexander Brobeil; Achim Weber; Mathias Heikenwalder; Harald Zur Hausen; Ethel-Michele de Villiers Journal: Proc Natl Acad Sci U S A Date: 2021-03-23 Impact factor: 12.779