Healthy lifestyle and risk of breast cancer among postmenopausal women in the European Prospective Investigation into Cancer and Nutrition cohort study
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Breast cancer is the most common cancer among women and prevention strategies are needed to reduce incidence worldwide. A healthy lifestyle index score (HLIS) was generated to investigate the joint effect of modifiable lifestyle factors on postmenopausal breast cancer risk. The study included 242,918 postmenopausal women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, with detailed information on diet and lifestyle assessed at baseline. The HLIS was constructed from five factors (diet, physical activity, smoking, alcohol consumption and anthropometry) by assigning scores of 0–4 to categories of each component, for which higher values indicate healthier behaviours. Hazard ratios (HR) were estimated by Cox proportional regression models. During 10.9 years of median follow-up, 7,756 incident breast cancer cases were identified. There was a 3% lower risk of breast cancer per point increase of the HLIS. Breast cancer risk was inversely associated with a high HLIS when fourth versus second (reference) categories were compared [adjusted HR = 0.74; 95% confidence interval (CI): 0.66–0.83]. The fourth versus the second category of the HLIS was associated with a lower risk for hormone receptor double positive (adjusted HR = 0.81, 95% CI: 0.67–0.98) and hormone receptor double negative breast cancer (adjusted HR = 0.60, 95% CI: 0.40–0.90). Findings suggest having a high score on an index of combined healthy behaviours reduces the risk of developing breast cancer among postmenopausal women. Programmes which engage women in long term health behaviours should be supported.
Date Issued
2014-11-16
Date Acceptance
2014-09-19
Citation
International Journal of Cancer, 2014, 136 (11), pp.2640-2648
ISSN
1097-0215
Publisher
Wiley
Start Page
2640
End Page
2648
Journal / Book Title
International Journal of Cancer
Volume
136
Issue
11
Copyright Statement
© 2014 UICC. This is the accepted version of the following article: McKenzie, F., Ferrari, P., Freisling, H., Chajès, V., Rinaldi, S., de Batlle, J., Dahm, C. C., Overvad, K., Baglietto, L., Dartois, L., Dossus, L., Lagiou, P., Trichopoulos, D., Trichopoulou, A., Krogh, V., Panico, S., Tumino, R., Rosso, S., Bueno-de-Mesquita, H. B., May, A., Peeters, P. H., Weiderpass, E., Buckland, G., Sanchez, M.-J., Navarro, C., Ardanaz, E., Andersson, A., Sund, M., Ericson, U., Wirfält, E., Key, T. J., Travis, R. C., Gunter, M., Riboli, E., Vergnaud, A.-C. and Romieu, I. (2015), Healthy lifestyle and risk of breast cancer among postmenopausal women in the European Prospective Investigation into Cancer and Nutrition cohort study. Int. J. Cancer, 136: 2640–2648. doi:10.1002/ijc.29315, which has been published in final form at https://dx.doi.org/10.1002/ijc.29315
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000351357700015&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Oncology
breast cancer
healthy index
lifestyle
prospective studies
Europe
CORONARY-HEART-DISEASE
CIGARETTE-SMOKING
GLYCEMIC INDEX
DIETARY FIBER
MEXICAN WOMEN
FATTY-ACIDS
METAANALYSIS
ASSOCIATION
PREVENTION
ADHERENCE
Alcohol Drinking
Anthropometry
Breast Neoplasms
Diet
European Continental Ancestry Group
Exercise
Female
Health Status
Humans
Life Style
Middle Aged
Postmenopause
Prospective Studies
Risk Factors
Risk Reduction Behavior
Women's Health
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status
Published