期刊
INTERNATIONAL JOURNAL OF CANCER
卷 137, 期 3, 页码 598-606出版社
WILEY
DOI: 10.1002/ijc.29411
关键词
healthy lifestyle score; gastric cancer; cohort; EPIC
类别
资金
- Europe Against Cancer Programme of the European Commission (SANCO)
- German Cancer Aid
- German Cancer Research Centre
- German Federal Ministry of Education and Research
- Danish Cancer Society
- Dutch Cancer Registry
- CIBER Epidemiologia y Salud Publica (CIBERESP), Spain
- Spanish Ministry of Health (ISCIII RETICC) [RD 06/0020/0091]
- Spanish Regional Government of Andalusia [6236]
- Spanish Regional Government of Asturias [6236]
- Spanish Regional Government of Basque Country [6236]
- Spanish Regional Government of Murcia [6236]
- Navarra and the Catalan Institute of Oncology (ICO-IDIBELL)
- Cancer Research UK
- Medical Research Council, UK
- Hellenic Health Foundation
- Italian Association for Research on Cancer
- Italian National Research Council
- Dutch Ministry of Public Health, Welfare and Sports
- Dutch Ministry of Health
- Dutch Prevention Funds
- LK Research Funds
- Dutch ZON (Zorg Onderzoek Nederland)
- World Cancer Research Fund (WCRF)
- Swedish Cancer Society
- Swedish Scientific Council
- Regional Government of Skane and Vasterbotten, Sweden
- Research Council of Norway
- Nordforsk Centre of Excellence programme in Food, Nutrition and Health (Helga), Associazione Italiana per la Ricerca sul Cancro-AIRC- (Italy)
- Cancer Research UK [14136, 16491] Funding Source: researchfish
- Medical Research Council [G1000143, G0401527] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10114] Funding Source: researchfish
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.
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