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Lifestyle after colorectal cancer diagnosis in relation to recurrence and all-cause mortality
- Source :
- The American Journal of Clinical Nutrition, The American journal of clinical nutrition 113 (2021) 6, The American journal of clinical nutrition, 113(6), 1447-1457, American Journal of Clinical Nutrition, 113(6), 1447-1457. Oxford University Press, The American Journal of Clinical Nutrition, 113, 1447-1457, The American Journal of Clinical Nutrition, 113, 6, pp. 1447-1457
- Publication Year :
- 2021
-
Abstract
- Background An unhealthy lifestyle is associated with the risk of colorectal cancer (CRC), but it is unclear whether overall lifestyle after a CRC diagnosis is associated with risks of recurrence and mortality. Objectives To examine associations between postdiagnosis lifestyle and changes in lifestyle after a CRC diagnosis with risks of CRC recurrence and all-cause mortality. Methods The study population included 1425 newly diagnosed, stage I–III CRC patients from 2 prospective cohort studies enrolled between 2010 and 2016. Lifestyle, including BMI, physical activity, diet, and alcohol intake, was assessed at diagnosis and at 6 months postdiagnosis. We assigned lifestyle scores based on concordance with 2 sets of cancer prevention guidelines—from the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and the American Cancer Society (ACS)—and national disease prevention guidelines. Higher scores indicate healthier lifestyles. We computed adjusted HRs and 95% CIs using Cox regression. Results We observed 164 recurrences during a 2.8-year median follow-up and 171 deaths during a 4.4-year median follow-up. No associations were observed for CRC recurrence. A lifestyle more consistent with the ACS recommendations was associated with a lower all-cause mortality risk (HR per +1 SD, 0.85; 95% CI: 0.73–0.995). The same tendency was observed for higher WCRF/AICR (HR, 0.92; 95% CI: 0.78–1.08) and national (HR, 0.90; 95% CI: 0.77–1.05) lifestyle scores, although these associations were statistically nonsignificant. Generally, no statistically significant associations were observed for BMI, physical activity, diet, or alcohol. Improving one's lifestyle after diagnosis (+1 SD) was associated with a lower all-cause mortality risk for the ACS (HR, 0.80; 95% CI: 0.67–0.96) and national (HR, 0.84; 95% CI: 0.70–0.999) scores, yet was statistically nonsignificant for the WCRF/AICR score (HR, 0.94; 95% CI: 0.78–1.13). Conclusions A healthy lifestyle after CRC diagnosis and improvements therein were not associated with the risk of CRC recurrence, but were associated with a decreased all-cause mortality risk.
- Subjects :
- medicine.medical_specialty
lifestyle
recurrence
Nutrition and Disease
Colorectal cancer
Concordance
Medicine (miscellaneous)
physical activity
body mass index
colorectal cancer
GUIDELINES
survival
AcademicSubjects/MED00160
Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]
03 medical and health sciences
AcademicSubjects/MED00060
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
COLON
Internal medicine
Voeding en Ziekte
medicine
030212 general & internal medicine
VALIDITY
Prospective cohort study
SQUASH
VLAG
Nutrition and Dietetics
Cancer prevention
business.industry
Proportional hazards model
alcohol
Cancer
medicine.disease
PREVENTION
Original Research Communications
PHYSICAL-ACTIVITY
Biometris
030220 oncology & carcinogenesis
SHORT QUESTIONNAIRE
Population study
HEALTH
business
diet
Body mass index
Subjects
Details
- Language :
- English
- ISSN :
- 00029165
- Volume :
- 113
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- The American journal of clinical nutrition
- Accession number :
- edsair.doi.dedup.....835c5ce2b3b04fce4a977001e7d68d2b