中国循证社会科学协作网

DOI

10.3389/fonc.2023.1162221

Association of modifiable lifestyle with colorectal cancer incidence and mortality according to metabolic status: prospective cohort study

Peng Xie ; Siqing Wu ; Zichong Kuo ; Huidong Tian ; Qiangsheng He ; Yanfei Li ; Ningning Mi ; Linmin Hu ; Haitong Zhao ; Wenjing Li ; Bin Xia ; Jinqiu Yuan ; Kehu Yang ; Changhua Zhang ; Yulong He

作者地址

Digestive Diseases Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China

通讯作者

Kehu Yang; Changhua Zhang; Yulong He

来源期刊

Frontiers in oncology

ISSN

2234-943X

出版日期

2023-05-30

卷号

页码

1162221

摘要

Background: Metabolic syndrome has been linked to an increased risk of colorectal cancer (CRC) incidence and mortality, but whether adopting a healthy lifestyle could attenuate the risk of CRC conferred by metabolic syndrome remains unclear. The aim of the study is to investigate the individual and joint effects of modifiable healthy lifestyle and metabolic health status on CRC incidence and mortality in the UK population. Methods: This prospective study included 328,236 individuals from the UK Biobank. An overall metabolic health status was assessed at baseline and categorized based on the presence or absence of metabolic syndrome. We estimated the association of the healthy lifestyle score (derived from 4 modifiable behaviors: smoking, alcohol consumption, diet, physical activity and categorized into "favorable," "intermediate", and "unfavorable") with CRC incidence and mortality, stratified by metabolic health status. Results: During a median follow-up of 12.5 years, 3,852 CRC incidences and 1,076 deaths from CRC were newly identified. The risk of incident CRC and its mortality increased with the number of abnormal metabolic factors and decreased with healthy lifestyle score (P trend = 0.000). MetS was associated with greater CRC incidence (HR = 1.24, 95% CI: 1.16 - 1.33) and mortality (HR = 1.24, 95% CI: 1.08 - 1.41) when compared with those without MetS. An unfavorable lifestyle was associated with an increased risk (HR = 1.25, 95% CI: 1.15 - 1.36) and mortality (HR = 1.36, 95% CI: 1.16 - 1.59) of CRC across all metabolic health status. Participants adopting an unfavorable lifestyle with MetS had a higher risk (HR = 1.56, 95% CI: 1.38 - 1.76) and mortality (HR = 1.75, 95% CI: 1.40 - 2.20) than those adopting a favorable healthy lifestyle without MetS. Conclusion: This study indicated that adherence to a healthy lifestyle could substantially reduce the burden of CRC regardless of the metabolic status. Behavioral lifestyle changes should be encouraged for CRC prevention even in participants with MetS.

关键词

CRC healthy lifestyle incidence metabolic syndrome mortality

资助信息

Natural Science Foundation of China (82003524, 82003408, 82103913, and 82204123); the Startup Fund for the 100 Top Talents Program, SYSU (392012); Guangdong Provincial Key Laboratory of Digestive Cancer Research (2021B1212040006); He Yulong Expert Workstation (202104AC100001-B03)

资助机构

国家自然科学基金委员会 ; 中山大学 ; 广东省科学技术厅

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