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Healthy lifestyle and risk of breast cancer among postmenopausal women in the E uropean P rospective I nvestigation into C ancer and N utrition cohort study
Author(s) -
McKenzie Fiona,
Ferrari Pietro,
Freisling Heinz,
Chajès Veronique,
Rinaldi Sabina,
Batlle Jordi,
Dahm Christina C,
Overvad Kim,
Baglietto Laura,
Dartois Laureen,
Dossus Laure,
Lagiou Pagona,
Trichopoulos Dimitrios,
Trichopoulou Antonia,
Krogh Vittorio,
Panico Salvatore,
Tumino Rosario,
Rosso Stefano,
BuenodeMesquita H. Bas,
May Anne,
Peeters Petra H,
Weiderpass Elisabete,
Buckland Genevieve,
Sanchez MariaJose,
Navarro Carmen,
Ardanaz Eva,
Andersson Anne,
Sund Malin,
Ericson Ulrika,
Wirfält Elisabet,
Key Tim J,
Travis Ruth C,
Gunter Marc,
Riboli Elio,
Vergnaud AnneClaire,
Romieu Isabelle
Publication year - 2014
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.29315
Subject(s) - breast cancer , medicine , hazard ratio , confidence interval , prospective cohort study , cancer , lower risk , proportional hazards model , oncology , body mass index , gynecology
Breast cancer is the most common cancer among women and prevention strategies are needed to reduce incidence worldwide. A healthy lifestyle index score (HLIS) was generated to investigate the joint effect of modifiable lifestyle factors on postmenopausal breast cancer risk. The study included 242,918 postmenopausal women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, with detailed information on diet and lifestyle assessed at baseline. The HLIS was constructed from five factors (diet, physical activity, smoking, alcohol consumption and anthropometry) by assigning scores of 0–4 to categories of each component, for which higher values indicate healthier behaviours. Hazard ratios (HR) were estimated by Cox proportional regression models. During 10.9 years of median follow‐up, 7,756 incident breast cancer cases were identified. There was a 3% lower risk of breast cancer per point increase of the HLIS. Breast cancer risk was inversely associated with a high HLIS when fourth versus second (reference) categories were compared [adjusted HR = 0.74; 95% confidence interval (CI): 0.66–0.83]. The fourth versus the second category of the HLIS was associated with a lower risk for hormone receptor double positive (adjusted HR = 0.81, 95% CI: 0.67–0.98) and hormone receptor double negative breast cancer (adjusted HR = 0.60, 95% CI: 0.40–0.90). Findings suggest having a high score on an index of combined healthy behaviours reduces the risk of developing breast cancer among postmenopausal women. Programmes which engage women in long term health behaviours should be supported.