Healthy lifestyle and the risk of pancreatic cancer in the EPIC study

被引：0

作者：

Sabine Naudin

Vivian Viallon

Dana Hashim

Heinz Freisling

Mazda Jenab

Elisabete Weiderpass

Flavie Perrier

Fiona McKenzie

H Bas Bueno-de-Mesquita

Anja Olsen

Anne Tjønneland

Christina C. Dahm

Kim Overvad

Francesca R. Mancini

Vinciane Rebours

Marie-Christine Boutron-Ruault

Verena Katzke

Rudolf Kaaks

Manuela Bergmann

Heiner Boeing

Eleni Peppa

Anna Karakatsani

Antonia Trichopoulou

Valeria Pala

Giovana Masala

Salvatore Panico

Rosario Tumino

Carlotta Sacerdote

Anne M. May

Carla H. van Gils

Charlotta Rylander

Kristin Benjaminsen Borch

María Dolores Chirlaque López

Maria-Jose Sánchez

Eva Ardanaz

José Ramón Quirós

Pilar Amiano Exezarreta

Malin Sund

Isabel Drake

Sara Regnér

Ruth C. Travis

Nick Wareham

Dagfinn Aune

Elio Riboli

Marc J. Gunter

Eric J. Duell

Paul Brennan

Pietro Ferrari

机构：

[1] International Agency for Research on Cancer,Nutritional Methodology and Biostatistics Group

[2] World Health Organization,Department of Hematology and Oncology, Tisch Cancer Institute

[3] Icahn School of Medicine at Mount Sinai,Nutritional Epidemiology Group

[4] International Agency for Research on Cancer,Director Office

[5] World Health Organization,Environment and Radiation section

[6] International Agency for Research on Cancer,Departement for Determinants of Chronic Diseases (Former)

[7] World Health Organization,Department of Gastroenterology and Hepathology

[8] Agency for Research on Cancer,Department of Epidemiology and Biostatistics

[9] World Health Organization,Department of Public Health, Faculty of Health and Medical Sciences

[10] National Institute of Public Health and the Environment (RIVM),Section for Epidemiology, Department of Public Health

[11] University Medical Center,CESP, Faculté de médecine (USVQ), Université Paris

[12] School of Public Health,Sud, INSERM

[13] Imperial College London,Inserm UMR1018

[14] Danish Cancer Society Research Center,Pancreatology Department

[15] University of Copenhagen,Inserm UMR1149, DHU Unit

[16] Aarhus University,Division of Cancer Epidemiology

[17] Department of Cardiology,Pulmonary Medicine Department, School of Medicine

[18] Aalborg University Hospital,Epidemiology and Prevention Unit

[19] Université Paris-Saclay,Cancer Risk Factors and Life

[20] Institut Gustave Roussy,Style Epidemiology Unit

[21] Beaujon Hospital,Department of Clinical and Experimental Medecine

[22] AP-HP,Cancer Registry and Histopathology Department

[23] Paris-Diderot University,Unit of Cancer Epidemiology, Città della Salute e della Scienza University

[24] German Cancer Research Center (DKFZ),Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht

[25] German Institute of Human Nutrition,Department of Community Medicine, Faculty of Health Sciences, University of Tromsø

[26] Potsdam-Rehbrücke,Department of Epidemiology, Regional Health Council, IMIB

[27] Hellenic Health Foundation,Arrixaca

[28] National and Kapodistrian University of Athens,Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria

[29] ATTIKON University Hospital of Athens,Department of Surgical and Preoperative Sciences

[30] School of Medicine,Department of Clinical Sciences in Malmö

[31] National and Kapodistrian University of Athens,Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine

[32] Fondazione IRCCS Istituto Nazionale dei Tumori,MRC Epidemiology Unit, Institute of Metabolic Science

[33] Institute for Cancer Research,Department of Nutrition

[34] Prevention and Clinical Network - ISPRO,Department of Endocrinology, Morbid Obesity and Preventive Medicine

[35] University Federico II,Unit of Nutrition and Cancer

[36] Civic M.P.Arezzo Hospital,Genetic Epidemiology Group

[37] Hospital and Center for Cancer Prevention (CPO),undefined

[38] Utrecht University,undefined

[39] The Arctic University of Norway,undefined

[40] Murcia University,undefined

[41] Spanish Consortium for Research and Public Health (CIBERESP),undefined

[42] Universidad de Granada,undefined

[43] Navarra Public Health Institute,undefined

[44] IdiSNA,undefined

[45] Navarra Institute for Health Research,undefined

[46] Public Health Directorate,undefined

[47] Public Health Division of Gipuzkoa,undefined

[48] BioDonostia Research Institute,undefined

[49] Umeå University,undefined

[50] Lund University,undefined

来源：

European Journal of Epidemiology | 2020年 / 35卷

关键词：

Pancreatic cancer; Healthy Lifestyle Index; Population attributable fraction; EPIC; Prospective study;

D O I：

暂无

中图分类号：

学科分类号：

摘要：

Pancreatic cancer (PC) is a highly fatal cancer with currently limited opportunities for early detection and effective treatment. Modifiable factors may offer pathways for primary prevention. In this study, the association between the Healthy Lifestyle Index (HLI) and PC risk was examined. Within the European Prospective Investigation into Cancer and Nutrition cohort, 1113 incident PC (57% women) were diagnosed from 400,577 participants followed-up for 15 years (median). HLI scores combined smoking, alcohol intake, dietary exposure, physical activity and, in turn, overall and central adiposity using BMI (HLIBMI) and waist-to-hip ratio (WHR, HLIWHR), respectively. High values of HLI indicate adherence to healthy behaviors. Cox proportional hazard models with age as primary time variable were used to estimate PC hazard ratios (HR) and 95% confidence intervals (CI). Sensitivity analyses were performed by excluding, in turn, each factor from the HLI score. Population attributable fractions (PAF) were estimated assuming participants’ shift to healthier lifestyles. The HRs for a one-standard deviation increment of HLIBMI and HLIWHR were 0.84 (95% CI: 0.79, 0.89; ptrend = 4.3e−09) and 0.77 (0.72, 0.82; ptrend = 1.7e−15), respectively. Exclusions of smoking from HLIWHR resulted in HRs of 0.88 (0.82, 0.94; ptrend = 4.9e−04). The overall PAF estimate was 19% (95% CI: 11%, 26%), and 14% (6%, 21%) when smoking was removed from the score. Adherence to a healthy lifestyle was inversely associated with PC risk, beyond the beneficial role of smoking avoidance. Public health measures targeting compliance with healthy lifestyles may have an impact on PC incidence.

引用

页码：975 / 986

页数：11

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