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@article{Buckland:2015:10.1002/ijc.29411,
author = {Buckland, G and Travier, N and Huerta, JM and Bueno-de-Mesquita, HBA and Siersema, PD and Skeie, G and Weiderpass, E and Engeset, D and Ericson, U and Ohlsson, B and Agudo, A and Romieu, I and Ferrari, P and Freisling, H and Colorado-Yohar, S and Li, K and Kaaks, R and Pala, V and Cross, AJ and Riboli, E and Trichopoulou, A and Lagiou, P and Bamia, C and Boutron-Ruault, MC and Fagherazzi, G and Dartois, L and May, AM and Peeters, PH and Panico, S and Johansson, M and Wallner, B and Palli, D and Key, TJ and Khaw, KT and Ardanaz, E and Overvad, K and Tjonneland, A and Dorronsoro, M and Sanchez, MJ and Quiros, JR and Naccarati, A and Tumino, R and Boeing, H and Gonzalez, CA},
doi = {10.1002/ijc.29411},
journal = {International Journal of Cancer},
pages = {598--606},
title = {Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study},
url = {http://dx.doi.org/10.1002/ijc.29411},
volume = {137},
year = {2015}
}

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TY  - JOUR
AB  - Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trends<0.001. Population attributable risk calculations showed that 18.8% of all GC and 62.4% of cardia GC cases could have been prevented if participants in this population had followed the healthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC.
AU  - Buckland,G
AU  - Travier,N
AU  - Huerta,JM
AU  - Bueno-de-Mesquita,HBA
AU  - Siersema,PD
AU  - Skeie,G
AU  - Weiderpass,E
AU  - Engeset,D
AU  - Ericson,U
AU  - Ohlsson,B
AU  - Agudo,A
AU  - Romieu,I
AU  - Ferrari,P
AU  - Freisling,H
AU  - Colorado-Yohar,S
AU  - Li,K
AU  - Kaaks,R
AU  - Pala,V
AU  - Cross,AJ
AU  - Riboli,E
AU  - Trichopoulou,A
AU  - Lagiou,P
AU  - Bamia,C
AU  - Boutron-Ruault,MC
AU  - Fagherazzi,G
AU  - Dartois,L
AU  - May,AM
AU  - Peeters,PH
AU  - Panico,S
AU  - Johansson,M
AU  - Wallner,B
AU  - Palli,D
AU  - Key,TJ
AU  - Khaw,KT
AU  - Ardanaz,E
AU  - Overvad,K
AU  - Tjonneland,A
AU  - Dorronsoro,M
AU  - Sanchez,MJ
AU  - Quiros,JR
AU  - Naccarati,A
AU  - Tumino,R
AU  - Boeing,H
AU  - Gonzalez,CA
DO  - 10.1002/ijc.29411
EP  - 606
PY  - 2015///
SN  - 1097-0215
SP  - 598
TI  - Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study
T2  - International Journal of Cancer
UR  - http://dx.doi.org/10.1002/ijc.29411
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000354639200012&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/42725
VL  - 137
ER  -

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