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

Edoardo Botteri; Giulia Peveri; Paula Berstad; Vincenzo Bagnardi; Sairah L F Chen; Torkjel M Sandanger; Geir Hoff; Christina C Dahm; Christian S Antoniussen; Anne Tjønneland; Anne Kirstine Eriksen; Guri Skeie; Aurora Perez-Cornago; José María Huerta; Paula Jakszyn; Sophia Harlid; Björn Sundström; Aurelio Barricarte; Evelyn M Monninkhof; Jeroen W G Derksen; Matthias B Schulze; Bas Bueno-de-Mesquita; Maria-Jose Sánchez; Amanda J Cross; Konstantinos K Tsilidis; Maria Santucci De Magistris; Rudolf Kaaks; Verena Katzke; Joseph A Rothwell; Nasser Laouali; Gianluca Severi; Pilar Amiano; Paolo Contiero; Carlotta Sacerdote; Marcel Goldberg; Mathilde Touvier; Heinz Freisling; Vivian Viallon; Elisabete Weiderpass; Elio Riboli; Mazda Jenab; Pietro Ferrari

doi:10.14309/ajg.0000000000002065

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

Edoardo Botteri, Giulia Peveri, Paula Berstad, Vincenzo Bagnardi, Sairah L F Chen, Torkjel M Sandanger, Geir Hoff, Christina C Dahm, Christian S Antoniussen, Anne Tjønneland, Anne Kirstine Eriksen, Guri Skeie, Aurora Perez-Cornago, José María Huerta, Paula Jakszyn, Sophia Harlid, Björn Sundström, Aurelio Barricarte, Evelyn M Monninkhof, Jeroen W G DerksenMatthias B Schulze, Bas Bueno-de-Mesquita, Maria-Jose Sánchez, Amanda J Cross, Konstantinos K Tsilidis, Maria Santucci De Magistris, Rudolf Kaaks, Verena Katzke, Joseph A Rothwell, Nasser Laouali, Gianluca Severi, Pilar Amiano, Paolo Contiero, Carlotta Sacerdote, Marcel Goldberg, Mathilde Touvier, Heinz Freisling, Vivian Viallon, Elisabete Weiderpass, Elio Riboli, Mazda Jenab, Pietro Ferrari

Department of Public Health - Department of Epidemiology

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

8 Citations (Scopus)

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.

Original language	English
Journal	The American Journal of Gastroenterology
Volume	118
Issue	4
Pages (from-to)	702-711
Number of pages	10
ISSN	0002-9270
DOIs	https://doi.org/10.14309/ajg.0000000000002065
Publication status	Published - Apr 2023

Keywords

Colorectal Neoplasms/epidemiology
Humans
Life Style
Nutritional Status
Prospective Studies
Risk Factors

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10.14309/ajg.0000000000002065

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Botteri, E., Peveri, G., Berstad, P., Bagnardi, V., Chen, S. L. F., Sandanger, T. M., Hoff, G., Dahm, C. C., Antoniussen, C. S., Tjønneland, A., Eriksen, A. K., Skeie, G., Perez-Cornago, A., Huerta, J. M., Jakszyn, P., Harlid, S., Sundström, B., Barricarte, A., Monninkhof, E. M., ... Ferrari, P. (2023). Changes in Lifestyle and Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition. The American Journal of Gastroenterology, 118(4), 702-711. https://doi.org/10.14309/ajg.0000000000002065

@article{8d3d8f279dfd4de5b7b1455929847e40,

title = "Changes in Lifestyle and Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition",

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.",

keywords = "Colorectal Neoplasms/epidemiology, Humans, Life Style, Nutritional Status, Prospective Studies, Risk Factors",

author = "Edoardo Botteri and Giulia Peveri and Paula Berstad and Vincenzo Bagnardi and Chen, {Sairah L F} and Sandanger, {Torkjel M} and Geir Hoff and Dahm, {Christina C} and Antoniussen, {Christian S} and Anne Tj{\o}nneland and Eriksen, {Anne Kirstine} and Guri Skeie and Aurora Perez-Cornago and Huerta, {Jos{\'e} Mar{\'i}a} and Paula Jakszyn and Sophia Harlid and Bj{\"o}rn Sundstr{\"o}m and Aurelio Barricarte and Monninkhof, {Evelyn M} and Derksen, {Jeroen W G} and Schulze, {Matthias B} and Bas Bueno-de-Mesquita and Maria-Jose S{\'a}nchez and Cross, {Amanda J} and Tsilidis, {Konstantinos K} and {De Magistris}, {Maria Santucci} and Rudolf Kaaks and Verena Katzke and Rothwell, {Joseph A} and Nasser Laouali and Gianluca Severi and Pilar Amiano and Paolo Contiero and Carlotta Sacerdote and Marcel Goldberg and Mathilde Touvier and Heinz Freisling and Vivian Viallon and Elisabete Weiderpass and Elio Riboli and Mazda Jenab and Pietro Ferrari",

note = "Copyright {\textcopyright} 2022 by The American College of Gastroenterology.",

year = "2023",

month = apr,

doi = "10.14309/ajg.0000000000002065",

language = "English",

volume = "118",

pages = "702--711",

journal = "The American Journal of Gastroenterology",

issn = "0002-9270",

publisher = "Wolters Kluwer Health",

number = "4",

}

Botteri, E, Peveri, G, Berstad, P, Bagnardi, V, Chen, SLF, Sandanger, TM, Hoff, G, Dahm, CC , Antoniussen, CS, Tjønneland, A, Eriksen, AK, Skeie, G, Perez-Cornago, A, Huerta, JM, Jakszyn, P, Harlid, S, Sundström, B, Barricarte, A, Monninkhof, EM, Derksen, JWG, Schulze, MB, Bueno-de-Mesquita, B, Sánchez, M-J, Cross, AJ, Tsilidis, KK, De Magistris, MS, Kaaks, R, Katzke, V, Rothwell, JA, Laouali, N, Severi, G, Amiano, P, Contiero, P, Sacerdote, C, Goldberg, M, Touvier, M, Freisling, H, Viallon, V, Weiderpass, E, Riboli, E, Jenab, M & Ferrari, P 2023, 'Changes in Lifestyle and Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition', The American Journal of Gastroenterology, vol. 118, no. 4, pp. 702-711. https://doi.org/10.14309/ajg.0000000000002065

Changes in Lifestyle and Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition. / Botteri, Edoardo; Peveri, Giulia; Berstad, Paula et al.
In: The American Journal of Gastroenterology, Vol. 118, No. 4, 04.2023, p. 702-711.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Changes in Lifestyle and Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition

AU - Botteri, Edoardo

AU - Peveri, Giulia

AU - Berstad, Paula

AU - Bagnardi, Vincenzo

AU - Chen, Sairah L F

AU - Sandanger, Torkjel M

AU - Hoff, Geir

AU - Dahm, Christina C

AU - Antoniussen, Christian S

AU - Tjønneland, Anne

AU - Eriksen, Anne Kirstine

AU - Skeie, Guri

AU - Perez-Cornago, Aurora

AU - Huerta, José María

AU - Jakszyn, Paula

AU - Harlid, Sophia

AU - Sundström, Björn

AU - Barricarte, Aurelio

AU - Monninkhof, Evelyn M

AU - Derksen, Jeroen W G

AU - Schulze, Matthias B

AU - Bueno-de-Mesquita, Bas

AU - Sánchez, Maria-Jose

AU - Cross, Amanda J

AU - Tsilidis, Konstantinos K

AU - De Magistris, Maria Santucci

AU - Kaaks, Rudolf

AU - Katzke, Verena

AU - Rothwell, Joseph A

AU - Laouali, Nasser

AU - Severi, Gianluca

AU - Amiano, Pilar

AU - Contiero, Paolo

AU - Sacerdote, Carlotta

AU - Goldberg, Marcel

AU - Touvier, Mathilde

AU - Freisling, Heinz

AU - Viallon, Vivian

AU - Weiderpass, Elisabete

AU - Riboli, Elio

AU - Jenab, Mazda

AU - Ferrari, Pietro

PY - 2023/4

Y1 - 2023/4

N2 - 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.

AB - 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.

KW - Colorectal Neoplasms/epidemiology

KW - Humans

KW - Life Style

KW - Nutritional Status

KW - Prospective Studies

KW - Risk Factors

UR - http://www.scopus.com/inward/record.url?scp=85151312824&partnerID=8YFLogxK

U2 - 10.14309/ajg.0000000000002065

DO - 10.14309/ajg.0000000000002065

M3 - Journal article

C2 - 36227801

SN - 0002-9270

VL - 118

SP - 702

EP - 711

JO - The American Journal of Gastroenterology

JF - The American Journal of Gastroenterology

IS - 4

ER -

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

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