AI Chat Paper
Note: Please note that the following content is generated by AMiner AI. SciOpen does not take any responsibility related to this content.
{{lang === 'zh_CN' ? '文章概述' : 'Summary'}}
{{lang === 'en_US' ? '中' : 'Eng'}}
Chat more with AI
Powered by AMiner. Clicking this button will take you away from SciOpen.
Home Cancer Biology & Medicine Article
PDF (259.2 KB)
Cite
EndNote(RIS) BibTeX
Collect
Submit Manuscript AI Chat Paper
Show Outline
Outline
Show full outline
Hide outline
Outline
Show full outline
Hide outline
Original Article | Open Access

The power of a healthy lifestyle for cancer prevention: the example of colorectal cancer

Xuechen Chen1,2, Jie Ding1, Hengjing Li1,2, Prudence R. Carr3, Michael Hoffmeister1, Hermann Brenner1,4,5 ( )
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
Medical Faculty Heidelberg, Heidelberg University, Heidelberg 69120, Germany
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg 69120, Germany
Show Author Information

Abstract

Objective

We aimed to directly compare the estimated effects of adherence to a healthy lifestyle with those of risk predisposition according to known genetic variants affecting colorectal cancer (CRC) risk, to support effective risk communication for cancer prevention.

Methods

A healthy lifestyle score (HLS) was derived from 5 lifestyle factors: smoking, alcohol consumption, diet, physical activity, and body adiposity. The association of lifestyle and polygenic risk score (PRS) (based on 140 CRC-associated risk loci) with CRC risk was assessed with multiple logistic regression and compared through the genetic risk equivalent (GRE), a novel approach providing an estimate of the effects of adherence to a healthy lifestyle in terms of percentile differences in PRS.

Results

A higher HLS was associated with lower CRC risk (4,844 cases, 3,964 controls). Those adhering to all 5 healthy lifestyle factors had a 62% (95% CI 54%–68%) lower CRC risk than those adhering to ≤ 2 healthy lifestyle factors. The estimated effect of adherence to all 5 compared with ≤ 2 healthy lifestyle factors was as strong as the effect of having a 79 percentile (GRE 79, 95% CI 61–97) lower PRS. The association between a healthy lifestyle and CRC risk was independent of PRS level but was particularly pronounced among those with a family history of CRC in ≥ 1 first-degree relative (P-interaction = 0.0013).

Conclusions

A healthy lifestyle was strongly inversely associated with CRC risk. The large GRE indicated that CRC risk determined by polygenic risk may be offset to a substantial extent by adherence to a healthy lifestyle.

Keywords

Colorectal cancerhealthy lifestyle scorepolygenic risk scorefamily historygenetic risk equivalent

Electronic Supplementary Material

Download File(s)
cbm-19-11-1586_ESM.pdf (157.1 KB)

References

1
World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, DC: AICR; 2007. Available from: https://discovery.ucl.ac.uk/id/eprint/4841/1/4841.pdf [Accessed February 27, 2022].
2

Bailey RR, Phad A, McGrath R, Haire-Joshu D. Prevalence of five lifestyle risk factors among U.S. adults with and without stroke. Disabil Health J. 2019; 12: 323-7.
Crossref Google Scholar
3

Zhu N, Yu C, Guo Y, Bian Z, Han Y, Yang L, et al. Adherence to a healthy lifestyle and all-cause and cause-specific mortality in Chinese adults: a 10-year prospective study of 0.5 million people. Int J Behav Nutr Phys Act. 2019; 16: 98.
Crossref Google Scholar
4

Atzendorf J, Apfelbacher C, de Matos EG, Lochbühler K, Piontek D, Seitz NN, et al. Do smoking, nutrition, alcohol use, and physical activity vary between regions in Germany? Results of a crosssectional study. BMC Public Health. 2020; 20: 277.
Crossref Google Scholar
5

Sweeney-Magee M, Gotay C, Ehsanul Karim M, Telford J, Dummer T. Patterns and determinants of adherence to colorectal cancer primary and secondary prevention recommendations in the BC Generations Project. Heal Promot Chronic Dis Prev Canada. 2022;42: 79-93.
Crossref Google Scholar
6

Ortiz C, López-Cuadrado T, Rodríguez-Blázquez C, PastorBarriuso R, Galán I. Clustering of unhealthy lifestyle behaviors, self-rated health and disability. Prev Med (Baltim). 2022; 155: 106911.
Crossref Google Scholar
7

Peters U, Jiao S, Schumacher FR, Hutter CM, Aragaki AK, Baron JA, et al. Identification of genetic susceptibility loci for colorectal tumors in a genome-wide meta-analysis. Gastroenterology. 2013;144: 799-807. e24.
Crossref Google Scholar
8

Whiffin N, Hosking FJ, Farrington SM, Palles C, Dobbins SE, Zgaga L, et al. Identification of susceptibility loci for colorectal cancer in a genome-wide meta-analysis. Hum Mol Genet. 2014; 23: 4729-37.
Crossref Google Scholar
9

Huyghe JR, Bien SA, Harrison TA, Kang HM, Chen S, Schmit SL, et al. Discovery of common and rare genetic risk variants for colorectal cancer. Nat Genet. 2019; 51: 76-87.
Crossref Google Scholar
10

Thomas M, Sakoda LC, Hoffmeister M, Rosenthal EA, Lee JK, van Duijnhoven FJB, et al. Genome-wide modeling of polygenic risk score in colorectal cancer risk. Am J Hum Genet. 2020; 107: 432-44.
Crossref Google Scholar
11

Chen X, Jansen L, Guo F, Hoffmeister M, Chang-Claude J, Brenner H. Smoking, genetic predisposition, and colorectal cancer risk. Clin Transl Gastroenterol. 2021; 12: e00317.
Crossref Google Scholar
12

Chen X, Guo F, Hoffmeister M, Chang-Claude J, Brenner H. Non-steroidal anti-inflammatory drugs, polygenic risk score and colorectal cancer risk. Aliment Pharmacol Ther. 2021; 54: 167-75.
Crossref Google Scholar
13

Chen X, Hoffmeister M, Brenner H. Red and processed meat intake, polygenic risk score, and colorectal cancer risk. Nutrients. 2022; 14: 1077.
Crossref Google Scholar
14

Chen X, Li H, Guo F, Hoffmeister M, Brenner H. Alcohol consumption, polygenic risk score, and early- and late-onset colorectal cancer risk. eClinicalMedicine. 2022; 49: 101460.
Crossref Google Scholar
15

Carr PR, Weigl K, Jansen L, Walter V, Erben V, Chang-Claude J, et al. Healthy lifestyle factors associated with lower risk of colorectal cancer irrespective of genetic risk. Gastroenterology. 2018; 155: 1805-15. e5.
Crossref Google Scholar
16

Carr PR, Weigl K, Edelmann D, Jansen L, Chang-Claude J, Brenner H, et al. Estimation of absolute risk of colorectal cancer based on healthy lifestyle, genetic risk, and colonoscopy status in a population-based study. Gastroenterology. 2020; 159: 129-38. e9.
Crossref Google Scholar
17

Cho YA, Lee J, Oh JH, Chang HJ, Sohn DK, Shin A, et al. Genetic risk score, combined lifestyle factors and risk of colorectal cancer. Cancer Res Treat. 2019; 51: 1033-40.
Crossref Google Scholar
18

Choi J, Jia G, Wen W, Shu X-O, Zheng W. Healthy lifestyles, genetic modifiers, and colorectal cancer risk: a prospective cohort study in the UK Biobank. Am J Clin Nutr. 2021; 113: 810-20.
Crossref Google Scholar
19

Brenner H, Chang–Claude J, Seiler CM, Rickert A, Hoffmeister M. Protection from colorectal cancer after colonoscopy: a populationbased, case-control study. Ann Intern Med. 2011; 154: 22-30.
Crossref Google Scholar
20

Brenner H, Chang–Claude J, Jansen L, Knebel P, Stock C, Hoffmeister M. Reduced risk of colorectal cancer up to 10 years after screening, surveillance, or diagnostic colonoscopy. Gastroenterology. 2014; 146: 709-17.
Crossref Google Scholar
21

Li H, Boakye D, Chen X, Jansen L, Chang-Claude J, Hoffmeister M, et al. Associations of body mass index at different ages with earlyonset colorectal cancer. Gastroenterology. 2022; 162: 1088-97. e3.
Crossref Google Scholar
22

Li X, Jansen L, Chang-Claude J, Hoffmeister M, Brenner H. Risk of colorectal cancer associated with lifetime excess weight. JAMA Oncol. 2022; 8: 730.
Crossref Google Scholar
23

Scherz H, Souci SW, editors. Food composition and nutrition tables. 5th ed. Stuttgart, Germany: Medpharm Scientific Publishers; 1994.
24
World Cancer Research Fund/American Institute for Cancer Research. Continuous update project report: diet, nutrition, physical activity and colorectal cancer. 2017. Available from: https://www.wcrf.org/wp-content/uploads/2021/02/Colorectal-cancerreport.pdf. [Accessed March 28, 2022].
25

Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003; 35: 1381-95.
Crossref Google Scholar
26

Tsoi KKF, Pau CYY, Wu WKK, Chan FKL, Griffiths S, Sung JJY. Cigarette smoking and the risk of colorectal cancer: a meta-analysis of prospective cohort studies. Clin Gastroenterol Hepatol. 2009; 7: 682-8. e5.
Crossref Google Scholar
27
World Health Organization. Global recommendations on physical activity for health. 2010. Available from: http://apps.who.int/iris/bitstream/handle/10665/44399/9789241599979_eng.pdf?sequence=1. [Accessed May 1, 2022].
28

Brenner H, Gefeller O, Greenland S. Risk and rate advancement periods as measures of exposure impact on the occurrence of chronic diseases. Epidemiology. 1993; 4: 229-36.
Crossref Google Scholar
29

Bishop YMM, Fienberg SE, Holland PW. Discrete multivariate analysis: theory and practice. MIT press; 1975.
30

Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960; 20: 37-46.
Crossref Google Scholar
31

Jeon J, Du M, Schoen RE, Hoffmeister M, Newcomb PA, Berndt SI, et al. Determining risk of colorectal cancer and starting age of screening based on lifestyle, environmental, and genetic factors. Gastroenterology. 2018; 154: 2152-64. e19.
Crossref Google Scholar
32

Peters U, Bien S, Zubair N. Genetic architecture of colorectal cancer. Gut. 2015; 64: 1623-36.
Crossref Google Scholar
33

Weigl K, Chang-Claude J, Knebel P, Hsu L, Hoffmeister M, Brenner H. Strongly enhanced colorectal cancer risk stratification by combining family history and genetic risk score. Clin Epidemiol. 2018; 10: 143-52.
Crossref Google Scholar
34

Theodoratou E, Campbell H, Tenesa A, McNeill G, Cetnarskyj R, Barnetson RA, et al. Modification of the associations between lifestyle, dietary factors and colorectal cancer risk by APC variants. Carcinogenesis. 2008; 29: 1774-80.
Crossref Google Scholar
35

Gay LJ, Mitrou PN, Keen J, Bowman R, Naguib A, Cooke J, et al. Dietary, lifestyle and clinicopathological factors associated with APC mutations and promoter methylation in colorectal cancers from the EPIC-Norfolk study. J Pathol. 2012; 228: 405-15.
Crossref Google Scholar
Cancer Biology & Medicine
Volume 19 Issue 11,
November 2022
Pages 1586-1597
DOI: 10.20892/j.issn.2095-3941.2022.0397
Cite this article:
Chen X, Ding J, Li H, et al. The power of a healthy lifestyle for cancer prevention: the example of colorectal cancer. Cancer Biology & Medicine, 2022, 19(11): 1586-1597. https://doi.org/10.20892/j.issn.2095-3941.2022.0397

100

Views

1

Downloads

6

Crossref

8

Web of Science

10

Scopus

Altmetrics
Received: 08 July 2022
Accepted: 25 August 2022
Published: 05 December 2022
©2022 Cancer Biology & Medicine.

Creative Commons Attribution-NonCommercial 4.0 International License
Return