Contributors: Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC); Organisation Mondiale de la Santé / World Health Organization Office Genève, Suisse (OMS / WHO); Cancer Registry of Norway; Università degli Studi di Milano = University of Milan (UNIMI); Karolinska Institutet Stockholm; Aarhus University Aarhus; Danish Cancer Society Research Center Copenhagen, Denmark (DCSRC); University of Copenhagen = Københavns Universitet (UCPH); Centre de recherche en épidémiologie et santé des populations (CESP); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay; Institut Gustave Roussy (IGR); German Cancer Research Center - Deutsches Krebsforschungszentrum Heidelberg (DKFZ); German Institute of Human Nutrition Potsdam-Rehbruecke Nuthetal, Germany (GIHNP-R); University of Potsdam = Universität Potsdam; German Center for Diabetes Research - Deutsches Zentrum für Diabetesforschung Neuherberg (DZD); Istituto per lo studio, la prevenzione e la rete oncologica = Institute for Cancer Research, Prevention and Clinical Network (ISPRO); IRCCS Istituto Nazionale dei Tumori Milano; University of Naples Federico II = Università degli studi di Napoli Federico II; Hyblean Association for Epidemiological Research; Università degli studi di Torino = University of Turin (UNITO); Universiteit Utrecht / Utrecht University Utrecht; Julius Center for Health Sciences and Primary Care; University Medical Center Utrecht (UMCU); Norwegian University of Science and Technology (NTNU); The Arctic University of Norway Tromsø, Norway (UiT); Public Health Directorate Asturias, Spain (PHD); L’Hospitalet de Llobregat Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge = Bellvitge Biomedical Research Institute (IDIBELL); Escuela Andaluza de Salud Publica (Granada.ibs); Hospitales Universitarios de Granada/Universidad de Granada-ibs.GRANADA Instituto de Investigación Biosanitaria Granada, Spain; Instituto Murciano de Investigación Biosanitaria Pascual Parrilla (IMIB); Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health (CIBERESP); Universidad de Granada = University of Granada (UGR); Ministry of Health of the Basque Government; Biodonostia Health Research Institute Donostia-San Sebastian, Spain (IIS Biodonostia); Murcia Regional Health Council Murcia; Universidad de Murcia; Navarra Institute for Health Research / Instituto de Investigación Sanitaria de Navarra (IdiSNA); Universidad Pública de Navarra Espagne = Public University of Navarra (UPNA)-Universidad de Navarra Pamplona (UNAV)-Clínica Universidad de Navarra Pamplona; Skane University Hospital Malmo; Skane University Hospital Lund; Lund University; University of Oxford; Imperial College London; Nutritional Epidemiology Research Team; Université Sorbonne Paris Nord-Centre for Research in Epidemiology and Statistics; Conservatoire National des Arts et Métiers CNAM (CNAM); HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers CNAM (CNAM); HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE); Université Paris Descartes - Paris 5 (UPD5); NKR; Netherlands Cancer Registry; Institut National de la Santé et de la Recherche Médicale; German Institute of Human Nutrition Potsdam-Rehbruecke; Kræftens Bekæmpelse; LK Research Funds; Zorg Onderzoek Nederland; FIS; World Cancer Research Fund; Bertrand Hemon and Carine Biessy; Bundesministerium für Bildung und Forschung; Cancerfonden; Dutch Prevention; Catalan Institute of Oncology - ICO; Centre International de Recherche sur le Cancer; Associazione Italiana per la Ricerca sul Cancro; Ministerie van Volksgezondheid, Welzijn en Sport; Health Research Fund; National Research Council; Institut Gustave-Roussy; National Institute for Public Health and the Environment; Rijksinstituut voor Volksgezondheid en Milieu; Consejería de Salud y Familias, Junta de Andalucía; NIHR Imperial Biomedical Research Centre; Deutsche Krebshilfe; Deutsches Krebsforschungszentrum; Compagnia di SanPaolo; Mutuelle Générale de l Education Nationale; Vetenskapsrådet; Institut National Du Cancer; Cancer Research UK; Medical Research Council; Department of Epidemiology and Biostatistics, University of California, San Francisco; Ligue Contre le Cancer; County Councils of Skåne; University of Maryland School of Public Health; Instituto de Salud Carlos III
نبذة مختصرة : International audience ; Background: Healthy lifestyles are inversely associated with the risk of noncommunicable diseases, which are leading causes of death. However, few studies have used longitudinal data to assess the impact of changing lifestyle behaviours on all-cause and cancer mortality. Methods: Within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, lifestyle profiles of 308,497 cancer-free adults (71% female) aged 35u201370 years at recruitment across nine countries were assessed with baseline and follow-up questionnaires administered on average of 7 years apart. A healthy lifestyle index (HLI), assessed at two time points, combined information on smoking status, alcohol intake, body mass index, and physical activity, and ranged from 0 to 16 units. A change score was calculated as the difference between HLI at baseline and follow-up. Associations between HLI change and all-cause and cancer mortality were modelled with Cox regression, and the impact of changing HLI on accelerating mortality rate was estimated by rate advancement periods (RAP, in years). Results: After the follow-up questionnaire, participants were followed for an average of 9.9 years, with 21,696 deaths (8407 cancer deaths) documented. Compared to participants whose HLIs remained stable (within one unit), improving HLI by more than one unit was inversely associated with all-cause and cancer mortality (hazard ratio [HR]: 0.84; 95% confidence interval [CI]: 0.81, 0.88; and HR: 0.87; 95% CI: 0.82, 0.92; respectively), while worsening HLI by more than one unit was associated with an increase in mortality (all-cause mortality HR: 1.26; 95% CI: 1.20, 1.33; cancer mortality HR: 1.19; 95% CI: 1.09, 1.29). Participants who worsened HLI by more than one advanced their risk of death by 1.62 (1.44, 1.96) years, while participants who improved HLI by the same amount delayed their risk of death by 1.19 (0.65, 2.32) years, compared to those with stable HLI. Conclusions: Making healthier lifestyle changes during ...
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