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Article Dans Une Revue BMC Medicine Année : 2024

Healthy lifestyle change and all-cause and cancer mortality in the European Prospective Investigation into Cancer and Nutrition cohort

1 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
2 Cancer Registry of Norway
3 UNIMI - Università degli Studi di Milano = University of Milan
4 Karolinska Institutet [Stockholm]
5 Aarhus University [Aarhus]
6 DCSRC - Danish Cancer Society Research Center [Copenhagen, Denmark]
7 UCPH - University of Copenhagen = Københavns Universitet
8 CESP - Centre de recherche en épidémiologie et santé des populations
9 IGR - Institut Gustave Roussy
10 DKFZ - German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg]
11 GIHNP-R - German Institute of Human Nutrition Potsdam-Rehbruecke [Nuthetal, Germany]
12 University of Potsdam = Universität Potsdam
13 DZD - German Center for Diabetes Research - Deutsches Zentrum für Diabetesforschung [Neuherberg]
14 ISPRO - Istituto per lo studio, la prevenzione e la rete oncologica = Institute for Cancer Research, Prevention and Clinical Network
15 IRCCS Istituto Nazionale dei Tumori [Milano]
16 University of Naples Federico II = Università degli studi di Napoli Federico II
17 Hyblean Association for Epidemiological Research
18 UNITO - Università degli studi di Torino = University of Turin
19 Universiteit Utrecht / Utrecht University [Utrecht]
20 Julius Center for Health Sciences and Primary Care
21 NTNU - Norwegian University of Science and Technology
22 UiT - The Arctic University of Norway [Tromsø, Norway]
23 PHD - Public Health Directorate [Asturias, Spain]
24 L’Hospitalet de Llobregat [Barcelona, Spain]
25 IDIBELL - Institut d'Investigació Biomèdica de Bellvitge = Bellvitge Biomedical Research Institute
26 Granada.ibs - Escuela Andaluza de Salud Publica
27 IMIB - Instituto Murciano de Investigación Biosanitaria Pascual Parrilla
28 CIBERESP - Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health
29 UGR - Universidad de Granada = University of Granada
30 Ministry of Health of the Basque Government
31 IIS Biodonostia - Biodonostia Health Research Institute [Donostia-San Sebastian, Spain]
32 Murcia Regional Health Council [Murcia]
33 Universidad de Murcia
34 IdiSNA - Navarra Institute for Health Research / Instituto de Investigación Sanitaria de Navarra
35 Skane University Hospital [Malmo]
36 Lund University
37 University of Oxford
38 Imperial College London
39 EREN [CRESS - U1153 / UMR_A 1125] - Nutritional Epidemiology Research Team | Equipe de Recherche en Epidémiologie Nutritionnelle
40 UPD5 - Université Paris Descartes - Paris 5

Résumé

Background: Healthy lifestyles are inversely associated with the risk of noncommunicable diseases, which are leading causes of death. However, few studies have used longitudinal data to assess the impact of changing lifestyle behaviours on all-cause and cancer mortality. Methods: Within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, lifestyle profiles of 308,497 cancer-free adults (71% female) aged 35u201370 years at recruitment across nine countries were assessed with baseline and follow-up questionnaires administered on average of 7 years apart. A healthy lifestyle index (HLI), assessed at two time points, combined information on smoking status, alcohol intake, body mass index, and physical activity, and ranged from 0 to 16 units. A change score was calculated as the difference between HLI at baseline and follow-up. Associations between HLI change and all-cause and cancer mortality were modelled with Cox regression, and the impact of changing HLI on accelerating mortality rate was estimated by rate advancement periods (RAP, in years). Results: After the follow-up questionnaire, participants were followed for an average of 9.9 years, with 21,696 deaths (8407 cancer deaths) documented. Compared to participants whose HLIs remained stable (within one unit), improving HLI by more than one unit was inversely associated with all-cause and cancer mortality (hazard ratio [HR]: 0.84; 95% confidence interval [CI]: 0.81, 0.88; and HR: 0.87; 95% CI: 0.82, 0.92; respectively), while worsening HLI by more than one unit was associated with an increase in mortality (all-cause mortality HR: 1.26; 95% CI: 1.20, 1.33; cancer mortality HR: 1.19; 95% CI: 1.09, 1.29). Participants who worsened HLI by more than one advanced their risk of death by 1.62 (1.44, 1.96) years, while participants who improved HLI by the same amount delayed their risk of death by 1.19 (0.65, 2.32) years, compared to those with stable HLI. Conclusions: Making healthier lifestyle changes during adulthood was inversely associated with all-cause and cancer mortality and delayed risk of death. Conversely, making unhealthier lifestyle changes was positively associated with mortality and an accelerated risk of death.
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hal-04623756 , version 1 (26-06-2024)

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Komodo Matta, Vivian Viallon, Edoardo Botteri, Giulia Peveri, Christina Dahm, et al.. Healthy lifestyle change and all-cause and cancer mortality in the European Prospective Investigation into Cancer and Nutrition cohort. BMC Medicine, 2024, 22 (1), pp.210. ⟨10.1186/s12916-024-03362-7⟩. ⟨hal-04623756⟩
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