Healthy lifestyle and the risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition study

被引：13

作者：

Naudin, Sabine ^{[1
]}

Margalef, Marta Solans ^{[2
,3
]}

Hosnijeh, Fatemeh Saberi ^{[4
]}

Nieters, Alexandra ^{[5
]}

Kyro, Cecilie ^{[6
]}

Tjonneland, Anne ^{[6
,7
]}

Dahm, Christina C. ^{[8
]}

Overvad, Kim ^{[8
,9
]}

Mahamat-Saleh, Yahya ^{[10
,11
]}

Besson, Caroline ^{[10
,12
]}

Boutron-Ruault, Marie-Christine ^{[10
,11
]}

Kuehn, Tilman ^{[13
]}

Canzian, Federico ^{[14
]}

Schulze, Matthias B. ^{[15
,16
]}

Peppa, Eleni ^{[17
]}

Karakatsani, Anna ^{[17
,18
]}

Trichopoulou, Antonia ^{[17
]}

Sieri, Sabina ^{[19
]}

Masala, Giovana ^{[20
]}

Panico, Salvatore ^{[21
]}

Tumino, Rosario ^{[22
]}

Ricceri, Fulvio ^{[23
,24
]}

Chen, Sairah L. F. ^{[25
]}

Barroso, Leila L. ^{[26
]}

Huerta, Jose M. ^{[27
,28
]}

Sanchez, Maria-Jose ^{[28
,29
,30
,31
]}

Ardanaz, Eva ^{[28
,32
,33
]}

Menendez, Virginia ^{[34
]}

Exezarreta, Pilar Amiano ^{[28
,35
]}

Spaeth, Florentin ^{[36
]}

Jerkeman, Mats ^{[37
]}

Jirstom, Karin ^{[38
]}

Schmidt, Julie A. ^{[39
]}

Aune, Dagfinn ^{[40
,41
,42
]}

Weiderpass, Elisabete ^{[43
]}

Riboli, Elio ^{[40
]}

Vermeulen, Roel ^{[4
]}

Casabonne, Delphine ^{[2
,44
]}

Gunter, Marc ^{[45
]}

Brennan, Paul ^{[46
]}

Ferrari, Pietro ^{[1
]}

机构：

[1] WHO, Int Agcy Res Canc, Nutr Methodol & Biostat Grp, Lyon, France

[2] CIBERESP, Madrid, Spain

[3] Univ Girona, Res Grp Stat Econometr & Hlth GRECS, Girona, Spain

[4] Univ Utrecht, Div Environm Epidemiol, Inst Risk Assessment Sci, Utrecht, Netherlands

[5] Med Ctr Univ Freiburg, Inst Immunodeficiency, Res Grp Epidemiol, Freiburg, Germany

[6] Danish Canc Soc Res Ctr, Copenhagen, Denmark

[7] Univ Copenhagen, Fac Hlth & Med Sci, Dept Publ Hlth, Copenhagen, Denmark

[8] Aarhus Univ, Dept Publ Hlth, Sect Epidemiol, Aarhus, Denmark

[9] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark

[10] Univ Paris Saclay, INSERM, UVSQ, CESP,Fac Med,Univ Paris Sud, Villejuif, France

[11] Gustave Roussy, Villejuif, France

[12] Hosp Versailles, Dept Hematol & Oncol, Le Chesnay, France

[13] German Canc Res Ctr, Div Canc Epidemiol, Heidelberg, Germany

[14] German Canc Res Ctr, Genom Epidemiol Grp, Heidelberg, Germany

[15] German Inst Human Nutr, Dept Mol Epidemiol, Nuthetal, Germany

[16] Univ Potsdam, Inst Nutr Sci, Nuthetal, Germany

[17] Hellen Hlth Fdn, Athens, Greece

[18] Natl & Kapodistrian Univ Athens, ATTIKON Univ Hosp, Sch Med, Pulm Med Dept, Haidari, Greece

[19] Fdn IRCCS Ist Nazl Tumori Milano, Epidemiol & Prevent Unit, Milan, Italy

[20] Inst Canc Res Prevent & Clin Network ISPRO, Canc Risk Factors & Life Style Epidemiol Unit, Florence, Italy

[21] Univ Federico II, Dept Clin & Expt Med, Naples, Italy

[22] Azienda Sanitaria Prov Asp Ragusa, Canc Registry & Histopathol Dept, Ragusa, Italy

[23] Univ Turin, Dept Clin & Biol Sci, Turin, Italy

[24] Reg Hlth Serv ASL TO3, Unit Epidemiol, Grugliasco, TO, Italy

[25] Norges Arktiske Univ, UiT, Helsevitenskapelige Fak, Inst Samfunnsmed, Tromso, Norway

[26] Catalan Inst Oncol ICO IDIBELL, Unit Nutr & Canc, Canc Epidemiol Res Program, Barcelona, Spain

[27] Murcia Reg Hlth Council, Dept Epidemiol, IMIB Arrixaca, Murcia, Spain

[28] Spanish Consortium Res & Publ Hlth CIBERESP, Madrid, Spain

[29] Andalusian Sch Publ Hlth EASP, Granada, Spain

[30] Inst Invest Biosanitaria Granada Ibs GRANADA, Granada, Spain

[31] Univ Granada UGR, Granada, Spain

[32] Navarra Publ Hlth Inst, Pamplona, Spain

[33] Navarra Inst Hlth Res, IdiSNA, Pamplona, Spain

[34] Publ Hlth Directorate, Asturias, Spain

[35] Minist Hlth Basque Govt, Biodonostia Hlth Res Inst, Publ Hlth Div Gipuzkoa, San Sebastian, Spain

[36] Umea Univ, Dept Radiat Sci & Oncol, Umea, Sweden

[37] Lund Univ, Div Oncol, Malmo, Sweden

[38] Lund Univ, Dept Clin Sci Lund Oncol & Therapeut Pathol, Lund, Sweden

[39] Univ Oxford, Nuffield Dept Populat Hlth, Canc Epidemiol Unit, Oxford, England

[40] Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England

[41] Bjorknes Univ Coll, Dept Nutr, Oslo, Norway

[42] Oslo Univ Hosp, Dept Endocrinol Morbid Obes & Prevent Med, Oslo, Norway

[43] WHO, Int Agcy Res Canc, Lyon, France

[44] Catalan Inst Oncol ICO IDIBELL, Unit Mol & Genet Epidemiol Infect & Canc, Barcelona, Spain

[45] WHO, Int Agcy Res Canc, Nutr Epidemiol Grp, Lyon, France

[46] WHO, Int Agcy Res Canc, Genet Epidemiol Grp, Lyon, France

来源：

INTERNATIONAL JOURNAL OF CANCER | 2020年 / 147卷 / 06期

基金：

英国医学研究理事会; 英国惠康基金;

关键词：

Hodgkin lymphoma; non-Hodgkin lymphoma; healthy lifestyle index; EPIC; prospective study; CIGARETTE-SMOKING; HODGKINS-LYMPHOMA; REGRESSION; UPDATE;

D O I：

10.1002/ijc.32977

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Limited evidence exists on the role of modifiable lifestyle factors on the risk of lymphoma. In this work, the associations between adherence to healthy lifestyles and risks of Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) were evaluated in a large-scale European prospective cohort. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), 2,999 incident lymphoma cases (132 HL and 2,746 NHL) were diagnosed among 453,808 participants after 15 years (median) of follow-up. The healthy lifestyle index (HLI) score combined information on smoking, alcohol intake, diet, physical activity and BMI, with large values of HLI expressing adherence to healthy behavior. Cox proportional hazards models were used to estimate lymphoma hazard ratios (HR) and 95% confidence interval (CI). Sensitivity analyses were conducted by excluding, in turn, each lifestyle factor from the HLI score. The HLI was inversely associated with HL, with HR for a 1-standard deviation (SD) increment in the score equal to 0.78 (95% CI: 0.66, 0.94). Sensitivity analyses showed that the association was mainly driven by smoking and marginally by diet. NHL risk was not associated with the HLI, with HRs for a 1-SD increment equal to 0.99 (0.95, 1.03), with no evidence for heterogeneity in the association across NHL subtypes. In the EPIC study, adherence to healthy lifestyles was not associated with overall lymphoma or NHL risk, while an inverse association was observed for HL, although this was largely attributable to smoking. These findings suggest a limited role of lifestyle factors in the etiology of lymphoma subtypes.

引用

页码：1649 / 1656

页数：8

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