Lifestyle changes in middle age and risk of cancer: evidence from the European Prospective Investigation into Cancer and Nutrition

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Botteri, Edoardo | Berstad, Paula | Hoff, Geir | Peveri, Giulia | Bagnardi, Vincenzo | Heath, Alicia K. | Cross, Amanda J. | Vineis, Paolo | Riboli, Elio | Gunter, Marc J. | Dossus, Laure | Johansson, Mattias | Freisling, Heinz | Matta, Komodo | Huybrechts, Inge | Weiderpass, Elisabete | Ferrari, Pietro | Chen, Sairah L.F. | B. Borch, Kristin | Sandanger, Torkjel M. | H. Nøst, Therese | Dahm, Christina C. | Antoniussen, Christian S. | Olsen, Anja | Tin Tin, Sandar | Fournier, Agnès | Marques, Chloé | Artaud, Fanny | Sánchez, Maria José | Guevara, Marcela | Santiuste, Carmen | Agudo, Antonio | Bajracharya, Rashmita | Katzke, Verena | Ricceri, Fulvio | Agnoli, Claudia | Bergmann, Manuela M. | Schulze, Matthias B. | Panico, Salvatore | Masala, Giovanna | Tjønneland, Anne | Stocks, Tanja | Manjer, Jonas | Aizpurua-Atxega, Amaia

Edité par CCSD ; Springer Verlag -

International audience. © Springer Nature B.V. 2023.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 cancersu2014including cancer of the breast, lung, colorectum, stomach, liver, cervix, oesophagus, bladder, and othersu2014using 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 0.95u20130.97). 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 1.07u20131.37) 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 0.65u20130.86) than those remaining in the bottom third. These results indicate that lifestyle changes in middle age may have a significant impact on cancer risk.

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