In a study reported in JAMA Oncology, Song and Giovannucci found that a “healthy lifestyle pattern” was associated with a reduced risk for carcinomas among white adults.
The study included data from the Nurses’ Health Study and the Health Professionals Follow-up Study. Carcinomas included all cancers except skin, brain, lymphatic, hematologic, and nonfatal prostate malignancies.
A healthy lifestyle pattern was defined as never or past smoking (pack-years < 5), no or moderate alcohol drinking (≤ 1 drink/d for women, ≤ 2 drinks/d for men), body mass index ≥ 18.5 and < 27.5 kg/m2, and weekly aerobic physical activity of ≥ 75 vigorous-intensity or 150 moderate-intensity minutes. All four criteria were met by 16,531 of 89,571 women and 11,731 of 46,339 men included in the analysis; these individuals constituted the low-risk group, with all others constituting the high-risk group. Population attributable risk (proportion of cases avoided if all individuals adopted the lifestyle of the low-risk population) was calculated as the difference in cancer rates between the low- and high-risk groups divided by the rate in the high-risk group.
Population attributable risks for total carcinoma incidence were 25% for women and 33% for men; population attributable risks for carcinoma mortality were 48% and 44%. Among individual cancers, population attributable risks for incidence in women and men were 82% and 78% for lung, 29% and 20% for colon and rectum, 30% and 29% for pancreatic, 36% and 44% for bladder, 36% and 4% for kidney, 16% and 38% for oral cavity and pharyngeal, 27% and 32% for liver, and 62% and 66% for esophageal cancers. Population attributable risks for incidence were 4% for breast, 21% for ovarian, 21% for endometrial cancers, and 21% for fatal prostate cancer. Population attributable risks for mortality were generally similar.
The investigators concluded: “A substantial cancer burden may be prevented through lifestyle modification. Primary prevention should remain a priority for cancer control.”
The study was supported by grants from the National Institutes of Health.
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