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Table 5 Population attributable risks (PARs) according to individual lifestyle factors and combined Healthy Lifestyle Index (HLI) a , the EPIC Cohort (1992 to 2010)

From: Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study

 

Colon cancer

Rectal cancer

Colorectal cancer

 

Cases, numberb

%PAR (95% CI)

Cases, numberb

%PAR (95% CI)

Cases, numberb

%PAR (95% CI)

All participants

      

Individual lifestyle factors c :

      

Overweight and obesity

1,231

10 (6 to 13)

671

3 (-1 to 7)

1,902

8 (5 to 11)

Physical activity

1,144

6 (2 to 10)

648

NA

1,792

3 (0 to 6)

Smoking

550

2 (-3 to 4)

378

4 (1 to 7)

928

4 (1 to 6)

Alcohol consumption

695

2 (-1 to 4)

462

6 (2 to 9)

1,157

4 (1 to 6)

Diet quality

1,084

5 (2 to 8)

629

5 (-2 to 9)

1,713

5 (2 to 7)

HLI <5 d

2,160

17 (6 to 26)

1,266

13 (-4 to 27)

3,426

16 (7 to 24)

Men

      

Individual lifestyle factors c :

      

Overweight and obesity

602

15 (8 to 21)

393

5 (-2 to 11)

995

10 (5 to 14)

Physical activity

515

4 (-2 to 9)

360

5 (-7 to 15)

875

3 (-1 to 6)

Smoking

289

1 (-2 to 4)

223

3 (-2 to 8)

512

4 (-3 to 11)

Alcohol consumption

377

5 (1 to 9)

287

12 (5 to 18)

664

7 (3 to 10)

Diet quality

451

4 (-1 to 9)

342

12 (3 to 20)

793

6 (1 to 10)

HLI <5 d

946

13 (-8 to 28)

686

36 (13 to 53)

1,632

22 (7 to 34)

Women

      

Individual lifestyle factors c :

      

Overweight and obesity

629

7 (2 to 11)

278

2 (-5 to 8)

907

5 (1 to 9)

Physical activity

629

7 (1 to 12)

288

NA

917

2 (-2 to 6)

Smoking

261

11 (-27 to 37)

155

2 (-2 to 6)

416

1 (-1 to 2)

Alcohol consumption

318

NA

175

2 (-2 to 6)

493

1 (-3 to 4)

Diet quality

633

6 (1 to10)

287

NA

920

2 (0 to 4)

HLI <5 d

1,214

20 (6 to 32)

580

NA

1,794

11 (1 to 21)

  1. aThe HLI (range 0 to 5 points) is calculated by summing the binary lifestyle factor variables (0,1) including overweight and obesity, physical activity, smoking, alcohol consumption and diet quality. Participants received one point if they had any of the following behaviours: healthy weight, physically active, non-smokers or former smokers, limited alcohol consumption or healthy diet quality. bThe number of cases denotes those cases without the healthy lifestyle factor or not adhering to all five healthy lifestyle factors. cPAR according to each of the individual lifestyle factors, stratified by EPIC study centre, and adjusted for age, sex, education (none, primary school, technical/professional school) and mutually adjusted for the other lifestyle factors, including overweight and obesity, physical activity, smoking, alcohol consumption and diet quality (binary variables). PARs are calculated by reversing the coding of the protective factors and taking into account the relative proportion of exposed cases based on the formula from Miettinen et al. [31]. The 95% CIs are calculated based on the formula of Whittemore et al. [33]. The PARs denote the percentage of colorectal cancer cases in the population that are attributable to the non-adherence to the particular healthy lifestyle factor. dPAR, stratified by EPIC study centre, and adjusted for age at study recruitment, sex and educational status (none, primary school, technical/professional school). The PAR denotes the percentage of colorectal cancer cases in the population that are attributable to the non-adherence to five healthy lifestyle behaviours. PARs are calculated based on a formula from Bruzzi et al. [32]. The 95% CIs are calculated based on the formula of Whittemore et al. [33]. Note: No meaningful PAR estimates were obtained for the associations of : physical activity and rectal cancer in all participants; alcohol consumption and colon cancer in women; as well as for physical activity and diet quality and rectal cancer in women, because the estimated hazard ratios for these individual factors in women were close to 1 (Please, see Table 3). CI, confidence interval; EPIC, European Prospective Investigation into Cancer and Nutrition.