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

作者：Helene Kirkegaard, Nina Føns Johnsen, Jane Christensen, Klaus Stensgaard Frederiksen, Kim Overvad, Anne Marie Tjønneland · 发表于：BMJ · 年份：2010 · DOI：10.1136/bmj.c5504 · 被引用次数：193 · 研究领域：Colorectal Cancer Screening and Detection、Nutritional Studies and Diet、Global Cancer Incidence and Screening

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 colorecta...