Healthy lifestyle and the risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition study
Author(s)
Type
Journal Article
Abstract
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.
Date Issued
2020-09-15
Date Acceptance
2020-02-14
Citation
International Journal of Cancer, 2020, 147 (6), pp.1649-1656
ISSN
0020-7136
Publisher
Wiley
Start Page
1649
End Page
1656
Journal / Book Title
International Journal of Cancer
Volume
147
Issue
6
Copyright Statement
© 2020 UICC. This is the accepted version of the following article: Naudin, S., Solans Margalef, M., Saberi Hosnijeh, F., Nieters, A., Kyrø, C., Tjønneland, A., Dahm, C.C., Overvad, K., Mahamat‐Saleh, Y., Besson, C., Boutron‐Ruault, M.‐C., Kühn, T., Canzian, F., Schulze, M.B., Peppa, E., Karakatsani, A., Trichopoulou, A., Sieri, S., Masala, G., Panico, S., Tumino, R., Ricceri, F., Chen, S.L., Barroso, L.L., Huerta, J.M., Sánchez, M.‐J., Ardanaz, E., Menéndez, V., Amiano Exezarreta, P., Spaeth, F., Jerkeman, M., Jirstom, K., Schmidt, J.A., Aune, D., Weiderpass, E., Riboli, E., Vermeulen, R., Casabonne, D., Gunter, M., Brennan, P. and Ferrari, P. (2020), Healthy lifestyle and the risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition study. Int. J. Cancer, which has been published in final form at https://doi.org/10.1002/ijc.32977
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000522279700001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Oncology
Hodgkin lymphoma
non-Hodgkin lymphoma
healthy lifestyle index
EPIC
prospective study
CIGARETTE-SMOKING
HODGKINS-LYMPHOMA
REGRESSION
UPDATE
Publication Status
Published
Date Publish Online
2020-03-16