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@article{Botteri:2022:10.14309/ajg.0000000000002065,
author = {Botteri, E and Peveri, G and Berstad, P and Bagnardi, V and Chen, SLF and Sandanger, TM and Hoff, G and Dahm, CC and Antoniussen, CS and Tjønneland, A and Eriksen, AK and Skeie, G and Perez-Cornago, A and Huerta, JM and Jakszyn, P and Harlid, S and Sundström, B and Barricarte, A and Monninkhof, EM and Derksen, JWG and Schulze, MB and Bueno-de-Mesquita, B and Sánchez, M-J and Cross, AJ and Tsilidis, KK and De, Magistris MS and Kaaks, R and Katzke, V and Rothwell, JA and Laouali, N and Severi, G and Amiano, P and Contiero, P and Sacerdote, C and Goldberg, M and Touvier, M and Freisling, H and Viallon, V and Weiderpass, E and Riboli, E and Gunter, MJ and Jenab, M and Ferrari, P},
doi = {10.14309/ajg.0000000000002065},
journal = {American Journal of Gastroenterology},
pages = {1--10},
title = {Changes in lifestyle and risk of colorectal cancer in the European prospective investigation into cancer and nutrition.},
url = {http://dx.doi.org/10.14309/ajg.0000000000002065},
volume = {10},
year = {2022}
}

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TY  - JOUR
AB  - INTRODUCTION: We investigated the impact of changes in lifestyle habits on colorectal cancer (CRC) risk in a multi-country European cohort. METHODS: We used baseline and follow-up questionnaire data from the EPIC cohort to assess changes in lifestyle habits and their associations with CRC development. We calculated a healthy lifestyle index (HLI) score based on smoking status, alcohol consumption, body mass index and physical activity collected at the two timepoints. HLI ranged from 0 (most unfavourable) to 16 (most favourable). We estimated the association between HLI changes and CRC risk using Cox regression models and reported hazard ratios (HR) with 95% confidence intervals (CI). RESULTS: Among 295,865 participants, 2,799 CRC cases were observed over a median of 7.8 years. Median time between questionnaires was 5.7 years. Each unit increase in HLI from the baseline to the follow-up assessment was associated with a statistically significant 3% lower CRC risk. Among participants in the top tertile at baseline (HLI>11), those in the bottom tertile at follow-up (HLI≤9) had a higher CRC risk (HR 1.34; 95%CI 1.02-1.75) than those remaining in the top tertile. Among individuals in the bottom tertile at baseline, those in the top tertile at follow-up had a lower risk (HR 0.77; 95%CI 0.59-1.00) than those remaining in the bottom tertile. DISCUSSION: Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention.
AU  - Botteri,E
AU  - Peveri,G
AU  - Berstad,P
AU  - Bagnardi,V
AU  - Chen,SLF
AU  - Sandanger,TM
AU  - Hoff,G
AU  - Dahm,CC
AU  - Antoniussen,CS
AU  - Tjønneland,A
AU  - Eriksen,AK
AU  - Skeie,G
AU  - Perez-Cornago,A
AU  - Huerta,JM
AU  - Jakszyn,P
AU  - Harlid,S
AU  - Sundström,B
AU  - Barricarte,A
AU  - Monninkhof,EM
AU  - Derksen,JWG
AU  - Schulze,MB
AU  - Bueno-de-Mesquita,B
AU  - Sánchez,M-J
AU  - Cross,AJ
AU  - Tsilidis,KK
AU  - De,Magistris MS
AU  - Kaaks,R
AU  - Katzke,V
AU  - Rothwell,JA
AU  - Laouali,N
AU  - Severi,G
AU  - Amiano,P
AU  - Contiero,P
AU  - Sacerdote,C
AU  - Goldberg,M
AU  - Touvier,M
AU  - Freisling,H
AU  - Viallon,V
AU  - Weiderpass,E
AU  - Riboli,E
AU  - Gunter,MJ
AU  - Jenab,M
AU  - Ferrari,P
DO  - 10.14309/ajg.0000000000002065
EP  - 10
PY  - 2022///
SN  - 0002-9270
SP  - 1
TI  - Changes in lifestyle and risk of colorectal cancer in the European prospective investigation into cancer and nutrition.
T2  - American Journal of Gastroenterology
UR  - http://dx.doi.org/10.14309/ajg.0000000000002065
UR  - https://www.ncbi.nlm.nih.gov/pubmed/36227801
UR  - https://journals.lww.com/ajg/Fulltext/9900/Changes_in_Lifestyle_and_Risk_of_Colorectal_Cancer.550.aspx
UR  - http://hdl.handle.net/10044/1/101141
VL  - 10
ER  -

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