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. 2015 Dec 28;10(12):e0143696.
doi: 10.1371/journal.pone.0143696. eCollection 2015.

The Joint Effects of Lifestyle Factors and Comorbidities on the Risk of Colorectal Cancer: A Large Chinese Retrospective Case-Control Study

Junjie Hang  1   2 , Binxin Cai  3 , Peng Xue  1   2 , Lei Wang  1   2 , Hai Hu  1   2 , Yangyang Zhou  1   2 , Shujuan Ren  1   2 , Jiajin Wu  3 , Meiying Zhu  3 , Donghui Chen  1   2 , Haiyan Yang  1   2 , Liwei Wang  1   2
Affiliations

The Joint Effects of Lifestyle Factors and Comorbidities on the Risk of Colorectal Cancer: A Large Chinese Retrospective Case-Control Study

Junjie Hang et al. PLoS One. .

Abstract

Background: Colorectal cancer (CRC) is a major cause of cancer morbidity and mortality. In previous epidemiologic studies, the respective correlation between lifestyle factors and comorbidity and CRC has been extensively studied. However, little is known about their joint effects on CRC.

Methods: We conducted a retrospective case-control study of 1,144 diagnosed CRC patients and 60,549 community controls. A structured questionnaire was administered to the participants about their socio-demographic factors, anthropometric measures, comorbidity history and lifestyle factors. Logistic regression model was used to calculate the odds ratio (ORs) and 95% confidence intervals (95%CIs) for each factor. According to the results from logistic regression model, we further developed healthy lifestyle index (HLI) and comorbidity history index (CHI) to investigate their independent and joint effects on CRC risk.

Results: Four lifestyle factors (including physical activities, sleep, red meat and vegetable consumption) and four types of comorbidity (including diabetes, hyperlipidemia, history of inflammatory bowel disease and polyps) were found to be independently associated with the risk of CRC in multivariant logistic regression model. Intriguingly, their combined pattern- HLI and CHI demonstrated significant correlation with CRC risk independently (ORHLI: 3.91, 95%CI: 3.13-4.88; ORCHI: 2.49, 95%CI: 2.11-2.93) and jointly (OR: 10.33, 95%CI: 6.59-16.18).

Conclusions: There are synergistic effects of lifestyle factors and comorbidity on the risk of colorectal cancer in the Chinese population.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The joint effects of lifestyle factors and comorbidities history on colorectal cancer risk.
Error bars indicate the 95%CI.
See this image and copyright information in PMC

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