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Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

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Title: Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study
Authors: Buckland, G
Travier, N
Huerta, JM
Bueno-de-Mesquita, HBA
Siersema, PD
Skeie, G
Weiderpass, E
Engeset, D
Ericson, U
Ohlsson, B
Agudo, A
Romieu, I
Ferrari, P
Freisling, H
Colorado-Yohar, S
Li, K
Kaaks, R
Pala, V
Cross, AJ
Riboli, E
Trichopoulou, A
Lagiou, P
Bamia, C
Boutron-Ruault, MC
Fagherazzi, G
Dartois, L
May, AM
Peeters, PH
Panico, S
Johansson, M
Wallner, B
Palli, D
Key, TJ
Khaw, KT
Ardanaz, E
Overvad, K
Tjonneland, A
Dorronsoro, M
Sanchez, MJ
Quiros, JR
Naccarati, A
Tumino, R
Boeing, H
Gonzalez, CA
Item Type: Journal Article
Abstract: Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trends<0.001. Population attributable risk calculations showed that 18.8% of all GC and 62.4% of cardia GC cases could have been prevented if participants in this population had followed the healthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC.
Issue Date: 13-Feb-2015
Date of Acceptance: 30-Sep-2014
URI: http://hdl.handle.net/10044/1/42725
DOI: http://dx.doi.org/10.1002/ijc.29411
ISSN: 1097-0215
Publisher: Wiley
Start Page: 598
End Page: 606
Journal / Book Title: International Journal of Cancer
Volume: 137
Issue: 3
Copyright Statement: © 2014 UICC. This is the accepted version of the following article: Buckland, G. et al (2015) Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study. International Journal of Cancer. 137 (3), 598-606, which has been published in final form at http://dx.doi.org/10.1002/ijc.29411.
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
healthy lifestyle score
gastric cancer
cohort
EPIC
CANCER-RISK
PHYSICAL-ACTIVITY
MEDITERRANEAN DIET
PRIMARY PREVENTION
COMBINED IMPACT
NUTRITION
MORTALITY
POPULATION
PROJECT
EURGAST
Adenocarcinoma
Adult
Europe
Female
Humans
Life Style
Male
Middle Aged
Population Surveillance
Prospective Studies
Risk
Stomach Neoplasms
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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