Healthy lifestyle and the risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition study.
Adult
Aged
Alcohol Drinking
/ adverse effects
Body Mass Index
Diet Surveys
/ statistics & numerical data
Europe
/ epidemiology
Exercise
/ physiology
Feeding Behavior
/ physiology
Female
Follow-Up Studies
Healthy Lifestyle
/ physiology
Humans
Incidence
Lymphoma
/ epidemiology
Male
Middle Aged
Prospective Studies
Risk Factors
Smoking
/ adverse effects
EPIC
Hodgkin lymphoma
healthy lifestyle index
non-Hodgkin lymphoma
prospective study
Journal
International journal of cancer
ISSN: 1097-0215
Titre abrégé: Int J Cancer
Pays: United States
ID NLM: 0042124
Informations de publication
Date de publication:
15 09 2020
15 09 2020
Historique:
received:
22
10
2019
revised:
03
02
2020
accepted:
14
02
2020
pubmed:
17
3
2020
medline:
15
4
2021
entrez:
17
3
2020
Statut:
ppublish
Résumé
Limited evidence exists on the role of modifiable lifestyle factors on the risk of lymphoma. In this work, the associations between adherence to healthy lifestyles and risks of Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) were evaluated in a large-scale European prospective cohort. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), 2,999 incident lymphoma cases (132 HL and 2,746 NHL) were diagnosed among 453,808 participants after 15 years (median) of follow-up. The healthy lifestyle index (HLI) score combined information on smoking, alcohol intake, diet, physical activity and BMI, with large values of HLI expressing adherence to healthy behavior. Cox proportional hazards models were used to estimate lymphoma hazard ratios (HR) and 95% confidence interval (CI). Sensitivity analyses were conducted by excluding, in turn, each lifestyle factor from the HLI score. The HLI was inversely associated with HL, with HR for a 1-standard deviation (SD) increment in the score equal to 0.78 (95% CI: 0.66, 0.94). Sensitivity analyses showed that the association was mainly driven by smoking and marginally by diet. NHL risk was not associated with the HLI, with HRs for a 1-SD increment equal to 0.99 (0.95, 1.03), with no evidence for heterogeneity in the association across NHL subtypes. In the EPIC study, adherence to healthy lifestyles was not associated with overall lymphoma or NHL risk, while an inverse association was observed for HL, although this was largely attributable to smoking. These findings suggest a limited role of lifestyle factors in the etiology of lymphoma subtypes.
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1649-1656Subventions
Organisme : Medical Research Council
ID : G1000143
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Organisme : Cancer Research UK
ID : C864/A14136
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/N003284/1
Pays : United Kingdom
Organisme : Cancer Research UK
ID : C8221/A19170
Pays : United Kingdom
Organisme : British Heart Foundation
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/M012190/1
Pays : United Kingdom
Organisme : Cancer Research UK
ID : 14136
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0401527
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC-UU_12015/1
Pays : United Kingdom
Organisme : Cancer Research UK
ID : C570/A16491
Pays : United Kingdom
Informations de copyright
© 2020 UICC.
Références
Turner JJ, Morton LM, Linet MS, et al. InterLymph hierarchical classification of lymphoid neoplasms for epidemiologic research based on the WHO classification (2008): update and future directions. Blood 2010;116:e90-8.
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424.
Evens AM, Antillón M, Aschebrook-Kilfoy B, et al. Racial disparities in Hodgkin's lymphoma: a comprehensive population-based analysis. Ann Oncol 2012;23:2128-37.
World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report 2018. Diet, nutrition, physical activity and pancreatic cancer. Washington, DC: WCRF/AICR. Available from: www.dietandcancerreport.org, 2018.
IARC. Absence of Excess Body Fatness/IARC Working Group on the Evaluation of Cancer-Preventive Interventions. IARC Handbooks of Cancer Prevention. Lyon, France: IARC, 2018. 658 Available from: http://publications.iarc.fr/570.
Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer 2015;112:580-93.
McKenzie F, Biessy C, Ferrari P, et al. Healthy lifestyle and risk of cancer in the European prospective investigation into cancer and nutrition cohort study. Medicine (Baltimore) 2016;95:e2850.
Riboli E, Hunt KJ, Slimani N, et al. European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection. Public Health Nutr 2002;5:1113-24.
Ferrari P, Day NE, Boshuizen HC, et al. The evaluation of the diet/disease relation in the EPIC study: considerations for the calibration and the disease models. Int J Epidemiol 2008;37:368-78.
Schoenfeld D. Partial residuals for the proportional hazards regression model. Biometrika 1982;69:239-41.
Heinzl H, Kaider A. Gaining more flexibility in Cox proportional hazards regression models with cubic spline functions. Comput Methods Programs Biomed 1997;54:201-8.
Lunn M, McNeil D. Applying cox regression to competing risks. Biometrics 1995;51:524-32.
StataCorp. Stata statistical software: release 14. College Station, TX: StataCorp LP, 2015.
Kabat GC, Matthews CE, Kamensky V, et al. Adherence to cancer prevention guidelines and cancer incidence, cancer mortality, and total mortality: a prospective cohort study. Am J Clin Nutr 2015;101:558-69.
Sergentanis T, Kanavidis P, Michelakos T, et al. Cigarette smoking and risk of lymphoma in adults. Eur J Cancer Prev 2013;22:131-50.
Mehta H, Nazzal K, Sadikot RT. Cigarette smoking and innate immunity. Inflamm Res 2008;57:497-503.
Epstein MM, Chang ET, Zhang Y, et al. Dietary pattern and risk of hodgkin lymphoma in a population-based case-control study. Am J Epidemiol 2015;182:405-16.
Solans M, Benavente Y, Saez M, et al. Inflammatory potential of diet and risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition. Eur J Nutr 2019;59:813-23.
Solans M, Benavente Y, Saez M, et al. Adherence to the mediterranean diet and lymphoma risk in the european prospective investigation into cancer and nutrition. Int J Cancer 2019;145:122-31.
Biggar RJ, Johansen JS, Smedby KE, et al. Serum YKL-40 and interleukin 6 levels in Hodgkin lymphoma. Clin Cancer Res 2008;14:6974-8.
Abar L, Sobiecki JG, Cariolou M, et al. Body size and obesity during adulthood, and risk of lympho-haematopoietic cancers: an update of the WCRF-AICR systematic review of published prospective studies. Ann Oncol 2019;30:528-41.
Bryant AJ, Newman JH. Alcohol intolerance associated with Hodgkin lymphoma. CMAJ 2013;185:E353.
Swerdlow S, Campo E, Harris N, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC, 2017 Available from: http://publications.iarc.fr/Book-And-Report-Series/Who-Iarc-Classification-Of-Tumours/Who-Classification-Of-Tumours-Of-Haematopoietic-And-Lymphoid-Tissues-2017. Accessed July 9, 2018.
Baan R, Grosse Y, Straif K, et al. A review of human carcinogens-part F: chemical agents and related occupations. Lancet Oncol 2009;10:1143-4.
Müller AMS, Ihorst G, Mertelsmann R, et al. Epidemiology of non-Hodgkin's lymphoma (NHL): trends, geographic distribution, and etiology. Ann Hematol 2005;84:1-12.