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Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

Buckland, G.; Travier, N.; Huerta, J. M.; Bueno-de-Mesquita, H. B(As); Siersema, P. D.; Skeie, G.; Weiderpass, E.; Engeset, D.; Ericson, Ulrika LU and Ohlsson, Bodil LU , et al. (2015) In International Journal of Cancer 137(3). p.598-606
Abstract
Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass... (More)
Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trends<0.001. Population attributable risk calculations showed that 18.8% of all GC and 62.4% of cardia GC cases could have been prevented if participants in this population had followed the healthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC. What's new? Several modifiable lifestyle factors, including smoking status, alcohol consumption, diet quality and weight, have been independently associated with gastric cancer. Behavioral patterns often cluster, however, lifestyle scores can be used to analyse overlapping risk factors. In this study, the authors used a healthy-lifestyle index to evaluate the combined effects of all of the above factors on the risk of developing gastric cancer (GC). They found that following a healthy lifestyle dramatically decreases the burden of gastric cancer. (Less)
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@article{e847a123-df9a-40e0-8685-320f927c005c,
  abstract     = {Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trends&lt;0.001. Population attributable risk calculations showed that 18.8% of all GC and 62.4% of cardia GC cases could have been prevented if participants in this population had followed the healthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC. What's new? Several modifiable lifestyle factors, including smoking status, alcohol consumption, diet quality and weight, have been independently associated with gastric cancer. Behavioral patterns often cluster, however, lifestyle scores can be used to analyse overlapping risk factors. In this study, the authors used a healthy-lifestyle index to evaluate the combined effects of all of the above factors on the risk of developing gastric cancer (GC). They found that following a healthy lifestyle dramatically decreases the burden of gastric cancer.},
  author       = {Buckland, G. and Travier, N. and Huerta, J. M. and Bueno-de-Mesquita, H. B(As) and Siersema, P. D. and Skeie, G. and Weiderpass, E. and Engeset, D. and Ericson, Ulrika and Ohlsson, Bodil and Agudo, A. and Romieu, I. and Ferrari, P. and Freisling, H. and Colorado-Yohar, S. and Li, K. and Kaaks, R. and Pala, V. and Cross, A. J. and Riboli, E. and Trichopoulou, A. and Lagiou, P. and Bamia, C. and Boutron-Ruault, M. C. and Fagherazzi, G. and Dartois, L. and May, A. M. and Peeters, P. H. and Panico, S. and Johansson, M. and Wallner, B. and Palli, D. and Key, T. J. and Khaw, K. T. and Ardanaz, E. and Overvad, K. and Tjonneland, A. and Dorronsoro, M. and Sanchez, M. J. and Quiros, J. R. and Naccarati, A. and Tumino, R. and Boeing, H. and Gonzalez, C. A.},
  issn         = {0020-7136},
  keyword      = {healthy lifestyle score,gastric cancer,cohort,EPIC},
  language     = {eng},
  number       = {3},
  pages        = {598--606},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study},
  url          = {http://dx.doi.org/10.1002/ijc.29411},
  volume       = {137},
  year         = {2015},
}