Uno study published on American Journal of Gastroenterology suggests that changes in smoking habits, alcohol consumption, body weight, and physical activity may modify the risk of developing colorectal cancer (CRC).
«This is a message that physicians and gastroenterologists can give to patients and CRC screening participants to improve CRC prevention,» write Edoardo Botteri, PhD, Norway Cancer Registry, Oslo, and colleagues.
Previous studies have shown a correlation between cancer in general and unhealthy lifestyle factors.They also demonstrated an association between weight gain and increased risk of CRC and a reduction in risk with smoking cessation. However, Botteri and colleagues write that they found no published research on the association of other lifestyle factors and specific risk of CRC.
To overcome this gap, 295,865 subjects (aged 35 to 70 years) who participated in the European Prospective Investigation into Cancer (EPIC) followed for a median of 7.8 years.
The researchers calculated a Healthy Lifestyle Index (HLI) score based on smoking status, alcohol consumption, body mass index (BMI) and physical activity. The median time between baseline and follow-up questionnaire was 5.7 years.
Participants’ scores ranged between 0 and 16.At baseline, the mean HLI score was 10.04, dropping slightly to 9.95 at follow-up.
Men showed more favorable changes than women; associations between HLI score and CRC risk were statistically significant only for men.
Overall, a 1 unit increase in HLI score was associated with a 3% lower risk of CRC.
Grouping HLI scores into tertiles, improvements from an «unfavorable lifestyle» (i.e. score 0–9) to a «favorable lifestyle» (i.e. score 12–16) were associated with a 23% lower risk of CRC (compared to no change at all). Similarly, decline from a «favorable lifestyle» to an «unfavorable lifestyle» was associated with a 34% higher risk.
Changes in BMI from baseline tended to be associated with CRC risk.
Reductions in alcohol consumption were significantly associated with a reduction in CRC risk in participants aged 55 years at baseline.
Increases in physical activity were significantly associated with a lower risk of proximal colon cancer, especially in younger participants.
However, reductions in smoking were associated with an increased risk of CRC.This correlation could be the result of «reverse causation,» the researchers note; i.e. subjects may have quit smoking because they developed early symptoms of CRC. Smoking showed only a marginal influence on HLI calculations in this study, because only a small percentage of participants changed their smoking rate.
Nutrition information was collected only at baseline; It was therefore not possible to measure changes in this factor. The researchers corrected the analysis for baseline feeding, acknowledging that the inability to include nutrition in the HLI score is a limitation of the study.
They also used educational attainment as an indicator of socioeconomic status, recognising that it is only an indicator.
«The HLI score may therefore not accurately capture the complex correlation between lifestyle habits and CRC risk,» they write.
If confirmed by other research, the results of this observational study could nevertheless provide evidence for designing interventional studies to prevent CRC, they conclude.
The article is an adaptation of the original, written by Laird Harrison, which appeared on Medscape.com, part of Medscape Professional Network.
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Source — https://www.univadis.it/viewarticle/cambiamenti-dello-stile-di-vita-possono-ridurre-il-rischio-di-sviluppare-tumore-colorettale