Adherence to Cancer Prevention Guidelines and Cancer Incidence and Mortality: A Population-Based Cohort Study
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Purpose This study aimed to estimate the risk of cancer incidence and mortality according to adherence to lifestyle-related cancer prevention guidelines. Materials and Methods Men and women who participated in the general health screening program in 2002 and 2003 provided by the National Health Insurance Service were included (n=8,325,492). Self-reported smoking, alcohol consumption, and physical activity habits and directly measured body mass index were collected. The participants were followed up until the date of cancer onset or death or 31 December 2018. The Cox proportional hazard model was used to evaluate the hazard ratio (HR) for cancer incidence and mortality according to different combinations of lifestyle behaviors. Results Only 6% of men and 15% of women engaged in healthy behavior at baseline, such as not smoking, not drinking alcohol, being moderately or highly physically active, and within a normal body mass index range. Compared to the best combination of healthy lifestyle behaviors, the weak and moderate associations with increased all cancer incidence (HR < 1.7) and mortality (HR < 2.5) were observed in those with heavy alcohol consumption and in former or current smokers. HRs of cancer mortality were significantly increased among current smokers in most combinations. Conclusion Compared to full adherence to cancer prevention recommendations, unhealthy behaviors increase cancer risk. As few people meet these recommendations, there is a great opportunity for cancer prevention.
Abstract
Purpose This study aimed to estimate the risk of cancer incidence and mortality according to adherence to lifestyle-related cancer prevention guidelines. Materials and Methods Men and women who participated in the general health screening program in 2002 and 2003 provided by the National Health Insurance Service were included (n=8,325,492). Self-reported smoking, alcohol consumption, and physical activity habits and directly measured body mass index were collected. The participants were followed up until the date of cancer onset or death or 31 December 2018. The Cox proportional hazard model was used to evaluate the hazard ratio (HR) for cancer incidence and mortality according to different combinations of lifestyle behaviors. Results Only 6% of men and 15% of women engaged in healthy behavior at baseline, such as not smoking, not drinking alcohol, being moderately or highly physically active, and within a normal body mass index range. Compared to the best combination of healthy lifestyle behaviors, the weak and moderate associations with increased all cancer incidence (HR < 1.7) and mortality (HR < 2.5) were observed in those with heavy alcohol consumption and in former or current smokers. HRs of cancer mortality were significantly increased among current smokers in most combinations. Conclusion Compared to full adherence to cancer prevention recommendations, unhealthy behaviors increase cancer risk. As few people meet these recommendations, there is a great opportunity for cancer prevention.
참고문헌 (36)
- Danaei G, "Causes of cancer in the world : comparative risk assessment of nine behavioural and environmental risk factors", Lancet, 366, pp.1784~1793 (2005)
- Schuz J, "European Code against Cancer 4th edition : 12 ways to reduce your cancer risk", Cancer Epidemiol, 39(Suppl 1), pp.S1~10 (2015)
- "Continuous update project expert report 2018. Recommendations and public health and policy implications" (2018)[URL]
- Rock CL, "American Cancer Society guideline for diet and physical activity for cancer prevention", CA Cancer J Clin, 70, pp.245~271 (2020)
- Kaluza J, "Adherence to the WCRF", AICR 2018 recommendations for cancer prevention and risk of cancer : prospective cohort studies of men and women, 2020, pp.122, 1562~1570
- Kabat GC, "Adherence to cancer prevention guidelines and cancer incidence, cancer mortality, and total mortality : a prospective cohort study", Am J Clin Nutr, 101, pp.558~569 (2015)
- Kohler LN, "Adherence to diet and physical activity cancer prevention guidelines and cancer outcomes : a systematic review", Cancer Epidemiol Biomarkers Prev, 25, pp.1018~1028 (2016)
- 홍세리, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2018", Cancer Research and Treatment, 53(2), pp.301~315 (2021), 대한암학회[DOI]
- "Lifestyle habits have a major impact on cancer", Dong-A Ilbo. 1991 Oct 11:30, 30~ (1991)
- "First step to cancer prevention, follow the code against cancer" (2006)[URL]
- "Avoid alcohol consumption! Get vaccine for cancer prevention!" (2016)[URL]
- Lee DH, "Lifestyle risk score and mortality in Korean adults : a population-based cohort study", Sci Rep, 10, pp.10260~ (2020)
- Yun JE, "Effects of a combined lifestyle score on 10-year mortality in Korean men and women : a prospective cohort study", BMC Public Health, 12, pp.673~ (2012)
- Seong SC, "Cohort profile : the National Health Insurance Service-National Health Screening Cohort(NHIS-HEALS)in Korea", BMJ Open, 7, pp.e016640~ (2017)
- Bang JS, "Clinical effect of a polysaccharide-rich extract of Acanthopanax senticosus on alcohol hangover", Pharmazie, 70, pp.269~273 (2015)
- Bagnardi V, "Alcohol consumption and site-specific cancer risk : a comprehensive dose-response meta-analysis", Br J Cancer, 112, pp.580~593 (2015)
- Feise RJ, "Do multiple outcome measures require p-value adjustment?", BMC Med Res Methodol, 2, pp.8~ (2002)
- Colditz GA, "Harvard report on cancer prevention volume 4 : Harvard Cancer Risk Index. Risk Index Working Group, Harvard Center for Cancer Prevention", Cancer Causes Control, 11, pp.477~488 (2000)
- "Awareness of ‘cancer is pre-ventable’ greatly improved in 10 years" (2017)[URL]
- Shams-White MM, "Operationalizing the 2018 World Cancer Research Fund", American Institute for Cancer Resear-ch(WCRF, Nutrients, pp.2019, 11[DOI]
- Park S, "Attributable fraction of tobacco smoking on cancer using population-based nationwide cancer incidence and mortality data in Korea", BMC Cancer, 14, pp.406~ (2014)
- 김소연, "Trends in health behaviors over 20 years : Findings from the 1998-2018 Korea National Health and Nutrition Examination Survey", Epidemiology and Health, 43, pp.1~12 (2021), 한국역학회[DOI]
- Organisation for Economic Co-operation and Development, "Health at a glance 2019: OECD indicators" (2019), OECD Publishing
- Park S, "Attributable fraction of alcohol consumption on cancer using population-based nationwide cancer incidence and mortalitydata in the Republic of Korea", BMC Cancer, 14, pp.420~ (2014)
- GBD 2016 Alcohol Collaborators, "Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016", Lancet, 392, pp.1015~1035 (2018)
- Naimi TS, "Selection biases in observational studies affect associations between ‘moderate’ alcohol consumption and mortality", Addiction, 112, pp.207~214 (2017)
- Stockwell T, "Do “moderate” drinkers have reduced mortality risk? A systematic review and meta-analysis of alcohol consumption and all-cause mortality", J Stud Alcohol Drugs, 77, pp.185~198 (2016)
- Ko H, "Low-level alcohol consumption and cancer mortality", Sci Rep, 11, pp.4585~ (2021)
- Viner B, "The individual and combined effects of alcohol consumption and cigarette smoking on site-specific cancer risk in a prospective cohort of 26, 607 adults : results from Alberta’s Tomorrow Project", Cancer Causes Control, 30, pp.1313~1326 (2019)
- French MT, "Do alcohol consumers exercise more? Findings from a national survey", Am J Health Promot, 24, pp.2~10 (2009)
- Chang JY, "Association of change in alcohol consumption with cardiovascular disease and mortality among initial nondrinkers", Sci Rep, 10, pp.13419~ (2020)
- Leasure JL, "Exercise and alcohol consumption : what we know, what we need to know, and why it is important", Front Psychiatry, 6, pp.156~ (2015)
- Park S, "Population-attributable causes of cancer in Korea : obesity and physical inactivity", PLoS One, 9, pp.e90871~ (2014)
- Yoonjung Kim, "Trends in the prevalence and management of major metabolic risk factors for chronic disease over 20 years: Findings from the 1998–2018 Korea National Health and Nutrition Examination Survey", Epidemiology and Health, 43, pp.1~12 (2021), 한국역학회[DOI]
- Lee PH, "Validity of the International Physical Activity Questionnaire Short Form(IPAQ-SF) : a systematic review", Int J Behav Nutr Phys Act, 8, pp.115~ (2011)
- Stockwell T, "Who under-reports their alcohol consumption in telephone surveys and by how much? : an application of the ‘yesterday method’ in a national Canadian substance use survey", Addiction, 109, pp.1657~1666 (2014)