Proportion of colon cancer attributable to lifestyle in a cohort of US women

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• 作者：Jennifer Erdrich ; Xuehong Zhang ; Edward Giovannucci…
• 关键词：Obesity ; Physical activity ; Smoking ; Calcium ; Multivitamin ; Alcohol ; Aspirin ; Screening ; Population attributable risk ; Colon cancer ; Prevention
• 刊名：Cancer Causes & Control
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：26
• 期：9
• 页码：1271-1279
• 全文大小：388 KB
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• 作者单位：Jennifer Erdrich (1)
  Xuehong Zhang (2)
  Edward Giovannucci (2) (3) (4)
  Walter Willett (2) (3) (4)
  
  1. General Surgery, Stanford University Medical Center, 300 Pasteur Drive Rm H3591, Stanford, CA, 94305, USA
  2. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
  3. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
  4. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  Cancer Research
  Public Health
  Epidemiology
  Hematology
  
• 出版者：Springer Netherlands
• ISSN：1573-7225

文摘

Background Many modifiable lifestyle factors have been associated with colon cancer risk, but less is known about their effect on disease when considered together. Estimating the proportion of colon cancer cases that could be prevented by the adoption of combined modifiable lifestyle behaviors will provide important insights into disease prevention. Methods In the Nurses-Health Study, we defined a low-risk group according to a combination of six factors: body mass index <25?kg/m2, physical activity of ?1 metabolic equivalent of task per week, alcohol consumption ?0?g/day, cigarette smoking <10 pack-years before the age of 30, current use of multivitamins for ?5?years, and total calcium intake ?00?mg/day. A composite risk score index was created and the population attributable risk (PAR%) was calculated after accounting for other known risk or protective factors. Results We documented 1,127 colon cancer cases among 81,092 over 24?years of follow-up. Compared with women in the lowest risk category, the women at all other exposure levels had a hazard ratio of colon cancer of 1.81 (95?% confidence interval 1.15-.85). The score index was significantly and linearly related to an increasing risk of colon cancer (p value for trend <0.0001). The PAR% of the six risk factors considered together in relation to colon cancer was 0.37 (95?% CI 0.09-.60). When regular aspirin use (two tablets/week for six or more years) was included with the other low-risk behaviors, the PAR% increased to 0.43 (95?% CI 0.14-.65). Conclusions Beyond the known benefit from colonoscopy/sigmoidoscopy, key behavior modifications and adherence to a healthy lifestyle could avoid approximately 37?% of colon cancer cases among women.