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. 2023 Apr 1;118(4):702-711.
doi: 10.14309/ajg.0000000000002065. Epub 2022 Oct 12.

Changes in Lifestyle and Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition

Edoardo Botteri  1   2 , Giulia Peveri  3   4 , Paula Berstad  1 , Vincenzo Bagnardi  5 , Sairah L F Chen  6 , Torkjel M Sandanger  6 , Geir Hoff  1   7 , Christina C Dahm  8 , Christian S Antoniussen  8 , Anne Tjønneland  9 , Anne Kirstine Eriksen  9 , Guri Skeie  6 , Aurora Perez-Cornago  10 , José María Huerta  11   12 , Paula Jakszyn  13 , Sophia Harlid  14 , Björn Sundström  15 , Aurelio Barricarte  12   16   17 , Evelyn M Monninkhof  18 , Jeroen W G Derksen  18 , Matthias B Schulze  19   20 , Bas Bueno-de-Mesquita  21 , Maria-Jose Sánchez  12   22   23   24 , Amanda J Cross  25 , Konstantinos K Tsilidis  25   26 , Maria Santucci De Magistris  27 , Rudolf Kaaks  28 , Verena Katzke  28 , Joseph A Rothwell  29 , Nasser Laouali  29 , Gianluca Severi  29   30 , Pilar Amiano  31   32   33 , Paolo Contiero  34 , Carlotta Sacerdote  35 , Marcel Goldberg  36 , Mathilde Touvier  37   38 , Heinz Freisling  39 , Vivian Viallon  39 , Elisabete Weiderpass  39 , Elio Riboli  25 , Marc J Gunter  39 , Mazda Jenab  39 , Pietro Ferrari  39
Affiliations

Changes in Lifestyle and Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition

Edoardo Botteri et al. Am J Gastroenterol. .

Abstract

Introduction: We investigated the impact of changes in lifestyle habits on colorectal cancer (CRC) risk in a multicountry European cohort.

Methods: We used baseline and follow-up questionnaire data from the European Prospective Investigation into Cancer cohort to assess changes in lifestyle habits and their associations with CRC development. We calculated a healthy lifestyle index (HLI) score based on smoking status, alcohol consumption, body mass index, and physical activity collected at the 2 time points. HLI ranged from 0 (most unfavorable) to 16 (most favorable). We estimated the association between HLI changes and CRC risk using Cox regression models and reported hazard ratios (HR) with 95% confidence intervals (CI).

Results: Among 295,865 participants, 2,799 CRC cases were observed over a median of 7.8 years. The median time between questionnaires was 5.7 years. Each unit increase in HLI from the baseline to the follow-up assessment was associated with a statistically significant 3% lower CRC risk. Among participants in the top tertile at baseline (HLI > 11), those in the bottom tertile at follow-up (HLI ≤ 9) had a higher CRC risk (HR 1.34; 95% CI 1.02-1.75) than those remaining in the top tertile. Among individuals in the bottom tertile at baseline, those in the top tertile at follow-up had a lower risk (HR 0.77; 95% CI 0.59-1.00) than those remaining in the bottom tertile.

Discussion: Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention.

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Comment in

  • Career and Race Are Associated With Cancer.
    Jin T, Huang M. Jin T, et al. Am J Gastroenterol. 2023 Apr 1;118(4):758. doi: 10.14309/ajg.0000000000002133. Epub 2022 Dec 7. Am J Gastroenterol. 2023. PMID: 36989432 No abstract available.

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