Pairwise association of key lifestyle factors and risk of colorectal cancer: a prospective pooled multicohort study

Abstract

Background Several lifestyle factors are associated with an increased risk of colorectal cancer (CRC). Although lifestyle factors co‐occur, in most previous studies these factors have been studied focusing upon a single risk factor or assuming independent effects between risk factors. Aim To examine the pairwise effects and interactions of smoking, alcohol consumption, physical inactivity, and body mass index (BMI) with risk of subsequent colorectal cancer (CRC). Methods and results We used METCA cohort data (pooled data from seven population‐based Finnish health behavior survey studies during years 1972–2015) consisting of 171 063 women and men. Participants' smoking, alcohol consumption, physical inactivity and BMI measures were gathered, and participants were categorized into those exposed and those not exposed. The incidence of CRC was modeled by Poisson regression with main and interaction effects of key lifestyle factors. The cohort members were followed‐up through register linkage to the Finnish Cancer Registry for first primary CRC case until the end of 2015. Follow‐up time was 1715, 690 person years. The highest pairwise CRC risk was among male smokers who had overweight (BMI ≥ 25 kg/m2) (HR 1.75, 95% CI 1.36–2.26) and women who had overweight and consumed alcohol (HR 1.45, 95% CI 1.14–1.85). Overall, among men the association of lifestyle factors and CRC risk was stronger than among women. In men, both having overweight and being a smoker combined with any other adverse lifestyle factor increased CRC risk. Among women, elevated CRC risks were observed for those who were physically inactive and who consumed alcohol or had overweight. No statistically significant interactions were detected between pairs of lifestyle factors. Conclusions This study strengthens the evidence of overweight, smoking, and alcohol consumption as CRC risk factors. Substantial protective benefits in CRC risk can be achieved by preventing smoking, maintaining BMI to <25 kg/m2 and not consuming alcohol.

Relationship between obesity indexes and triglyceride glucose index with gastrointestinal cancer among the US population

“…Previous prospective cohort studies have found that obesity-related markers are significantly related to the incidence of various cancers ( Parra-Soto et al, 2021 , Perez-Cornago et al, 2022 , Recalde et al, 2021 , Roos et al, 2024 ). In 2016 and 2020, according to the data in the European prospective investigation into cancer and nutrition study, researchers found that obesity has a significant impact on the incidence of colorectal cancer, esophageal cancer, and gastric cancer ( Murphy et al, 2016 , Sanikini et al, 2020 ).…”

Colorectal tumor comorbidity is common in patients with duodenal tumors: An exploratory cross-sectional study

“…The positive association between DETs and colorectal tumors might indicate shared risk factors for these two conditions, such as smoking, overweight, and red meat consumption that are known risk factors for colorectal tumors [17,18]. A systematic review regarding the risk factors for duodenal tumors [19] did not yield specific findings.…”

“…Demographic (age, sex) and clinical (body mass index (BMI), comorbidities, and family history of colorectal cancer) characteristics were not different between the two groups, with the exception of age (mean, 64 years, DET group, and 57 years, control group, p<.001). The most common location for DETs was the descending part and distal papilla of the duodenum, with a median (interquartile range [IQR]) lesion size of 15 [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] mm.…”

MicroRNA-nanoparticles against cancer: Opportunities and challenges for personalized medicine

“… 9 On the other hand, the most common sporadic forms of CRC showed higher incidence in people with obesity, sedentary life, and/or addicted to smoking and excessive alcohol consumption. 10 Despite improved treatments, patients with metastatic CRC generally have a median survival rate between 24 and 36 months and for several metastatic CRC forms the available treatments are not effective. 5 The strategies based on the combination of immunotherapy and radiotherapy and/or chemotherapy can synergistically improve the response of CRC patients to treatment, but still have limitations and induce severe side effects.…”