Association of adherence to lifestyle recommendations and risk of colorectal cancer: a prospective Danish cohort study

Abstract

Objectives To evaluate the association between a simple lifestyle index based on the recommendations for five lifestyle factors and the incidence of colorectal cancer, and to estimate the proportion of colorectal cancer cases attributable to lack of adherence to the recommendations. Design Prospective cohort study. Setting General population of Copenhagen and Aarhus, Denmark. Participants 55 487 men and women aged 50-64 years at baseline (1993-7), not previously diagnosed with cancer. Main outcome measure Risk of colorectal cancer in relation to points achieved in the lifestyle index (based on physical activity, waist circumference, smoking, alcohol intake, and diet (dietary fibre, energy percentage from fat, red and processed meat, and fruits and vegetables)) modelled through Cox regression. Results During a median follow-up of 9.9 years, 678 men and women had colorectal cancer diagnosed. After adjustment for potential confounders, each additional point achieved on the lifestyle index, corresponding to one additional recommendation that was met, was associated with a lower risk of colorectal cancer (incidence rate ratio 0.89 (95% confidence interval 0.82 to 0.96). In this population an estimated total of 13% (95% CI 4% to 22%) of the colorectal cancer cases were attributable to lack of adherence to merely one additional recommendation among all participants except the healthiest. If all participants had followed the five recommendations 23% (9% to 37%) of the colorectal cancer cases might have been prevented. Results were similar for colon and rectal cancer, but only statistically significant for colon cancer. Conclusions Adherence to the recommendations for physical activity, waist circumference, smoking, alcohol intake, and diet may reduce colorectal cancer risk considerably, and in this population 23% of the cases might be attributable to lack of adherence to the five lifestyle recommendations. The simple structure of the lifestyle index facilitates its use in public health practice.

S3-Leitlinie – Kolorektales Karzinom

“…Diese Befunde wurden allerdings noch nicht durch randomisierte Studien bestätigt [85]. Aufgrund der gehäuften Inzidenz von gastrointestinalen Blutungen unter 2 DaderBegriff"Hormonersatztherapie" irreführend ist, wird in der Leitlinie nur der Begriff "Hormontherapie" verwendet ASS [87] und der fehlenden Bewertung der Nutzen-/Risikorelation folgt die Leitliniengruppe der Leitlinie der U.S. Preventive Services Task Force zum Einsatz von ASS oder NSAR zur Primärprävention des kolorektalen Karzinoms aus dem Jahr 2007, die empfiehlt, ASS und NSAR nicht zur Primärprävention des kolorektalen Karzinoms einzusetzen [84]. Eine Hormontherapie kann das kolorektale Karzinomrisiko reduzieren [89].…”

Health behaviors and cancer screening among Californians with a family history of cancer

“…6 Approximately 23% of CRC cases could be prevented through the combination of no smoking, regular physical activity, limiting alcohol use, and maintaining a healthy diet and waist circumference. 12 Modification of dietary and lifestyle behaviors can reduce the risk of breast and CRC even in individuals with FMH of these cancers. 13,14 Although cancer screening test use is higher in persons with FMH of CRC 15,16 and breast cancer, 16 less is known about their health behaviors at the population-level.…”

A new insight into fecal hemoglobin concentration‐dependent predictor for colorectal neoplasia

“…To assess the predictive power of FHbC as a measure of risk of colorectal neoplasia one must develop a risk model based on FHbC (measured as a continuous variable at baseline in those testing both negative and positive according to the FIT) in addition to conventional risk factors. [14][15][16][17][18] Using a population-based longitudinal follow-up study of a community-based multiple screening program, which …”

“…To assess the predictive power of FHbC as a measure of risk of colorectal neoplasia one must develop a risk model based on FHbC (measured as a continuous variable at baseline in those testing both negative and positive according to the FIT) in addition to conventional risk factors. [14][15][16][17][18] Using a population-based longitudinal follow-up study of a community-based multiple screening program, which included screening for colorectal cancer with the FIT, we aimed to first examine how much of the variation in incidence of colorectal neoplasia is accounted for by baseline FHbC and then to assess the additional predictive value of conventional risk factors to the previous model. An overall risk score (for predicting the incident colorectal neoplasia) will be developed by combining both conventional risk factors and baseline FHbC.…”