TY - JOUR

T1 - Lifestyle changes in middle age and risk of cancer

T2 - evidence from the European Prospective Investigation into Cancer and Nutrition

AU - Botteri, Edoardo

AU - Peveri, Giulia

AU - Berstad, Paula

AU - Bagnardi, Vincenzo

AU - Hoff, Geir

AU - Heath, Alicia K.

AU - Cross, Amanda J.

AU - Vineis, Paolo

AU - Dossus, Laure

AU - Johansson, Mattias

AU - Freisling, Heinz

AU - Matta, Komodo

AU - Huybrechts, Inge

AU - Chen, Sairah L.F.

AU - B. Borch, Kristin

AU - Sandanger, Torkjel M.

AU - H. Nøst, Therese

AU - Dahm, Christina C.

AU - Antoniussen, Christian S.

AU - Tin Tin, Sandar

AU - Fournier, Agnès

AU - Marques, Chloé

AU - Artaud, Fanny

AU - Sánchez, Maria José

AU - Guevara, Marcela

AU - Santiuste, Carmen

AU - Agudo, Antonio

AU - Bajracharya, Rashmita

AU - Katzke, Verena

AU - Ricceri, Fulvio

AU - Agnoli, Claudia

AU - Bergmann, Manuela M.

AU - Schulze, Matthias B.

AU - Panico, Salvatore

AU - Masala, Giovanna

AU - Tjønneland, Anne

AU - Olsen, Anja

AU - Stocks, Tanja

AU - Manjer, Jonas

AU - Aizpurua-Atxega, Amaia

AU - Weiderpass, Elisabete

AU - Riboli, Elio

AU - Gunter, Marc J.

AU - Ferrari, Pietro

N1 - Publisher Copyright: © 2023, Springer Nature B.V.

PY - 2024

Y1 - 2024

N2 - In this study, we aimed to provide novel evidence on the impact of changing lifestyle habits on cancer risk. In the EPIC cohort, 295,865 middle-aged participants returned a lifestyle questionnaire at baseline and during follow-up. At both timepoints, we calculated a healthy lifestyle index (HLI) score based on cigarette smoking, alcohol consumption, body mass index and physical activity. HLI ranged from 0 (most unfavourable) to 16 (most favourable). We estimated the association between HLI change and risk of lifestyle-related cancers—including cancer of the breast, lung, colorectum, stomach, liver, cervix, oesophagus, bladder, and others—using Cox regression models. We reported hazard ratios (HR) with 95% confidence intervals (CI). Median time between the two questionnaires was 5.7 years, median age at follow-up questionnaire was 59 years. After the follow-up questionnaire, we observed 14,933 lifestyle-related cancers over a median follow-up of 7.8 years. Each unit increase in the HLI score was associated with 4% lower risk of lifestyle-related cancers (HR 0.96; 95%CI 0.95–0.97). Among participants in the top HLI third at baseline (HLI > 11), those in the bottom third at follow-up (HLI ≤ 9) had 21% higher risk of lifestyle-related cancers (HR 1.21; 95%CI 1.07–1.37) than those remaining in the top third. Among participants in the bottom HLI third at baseline, those in the top third at follow-up had 25% lower risk of lifestyle-related cancers (HR 0.75; 95%CI 0.65–0.86) than those remaining in the bottom third. These results indicate that lifestyle changes in middle age may have a significant impact on cancer risk.

AB - In this study, we aimed to provide novel evidence on the impact of changing lifestyle habits on cancer risk. In the EPIC cohort, 295,865 middle-aged participants returned a lifestyle questionnaire at baseline and during follow-up. At both timepoints, we calculated a healthy lifestyle index (HLI) score based on cigarette smoking, alcohol consumption, body mass index and physical activity. HLI ranged from 0 (most unfavourable) to 16 (most favourable). We estimated the association between HLI change and risk of lifestyle-related cancers—including cancer of the breast, lung, colorectum, stomach, liver, cervix, oesophagus, bladder, and others—using Cox regression models. We reported hazard ratios (HR) with 95% confidence intervals (CI). Median time between the two questionnaires was 5.7 years, median age at follow-up questionnaire was 59 years. After the follow-up questionnaire, we observed 14,933 lifestyle-related cancers over a median follow-up of 7.8 years. Each unit increase in the HLI score was associated with 4% lower risk of lifestyle-related cancers (HR 0.96; 95%CI 0.95–0.97). Among participants in the top HLI third at baseline (HLI > 11), those in the bottom third at follow-up (HLI ≤ 9) had 21% higher risk of lifestyle-related cancers (HR 1.21; 95%CI 1.07–1.37) than those remaining in the top third. Among participants in the bottom HLI third at baseline, those in the top third at follow-up had 25% lower risk of lifestyle-related cancers (HR 0.75; 95%CI 0.65–0.86) than those remaining in the bottom third. These results indicate that lifestyle changes in middle age may have a significant impact on cancer risk.

KW - Cancer risk

KW - Cohort study

KW - Healthy lifestyle index

KW - Lifestyle changes

U2 - 10.1007/s10654-023-01059-4

DO - 10.1007/s10654-023-01059-4

M3 - Journal article

C2 - 38180593

AN - SCOPUS:85181484483

VL - 39

SP - 147

EP - 159

JO - European Journal of Epidemiology

JF - European Journal of Epidemiology

SN - 0393-2990

ER -