ArticleBMJ open2024
Combined prediagnostic lifestyle factors and survival of breast, colorectal and lung cancer in the Norwegian Women and Cancer (NOWAC) study: a prospective cohort study.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Healthy lifestyles, screening, and breast cancer mortality in women with different risk of disease.The oncologist · 2025Article
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6 authors.
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Abstract
backgroundWith improvements in cancer treatment and early detection, the number of people living with cancer is increasing.
objectiveThis study aimed to investigate the association between combined prediagnostic lifestyle factors, assessed by a Healthy Lifestyle Index (HLI) score, and mortality among women diagnosed with breast cancer (BC), colorectal cancer (CRC) and lung cancer (LC).
designProspective cohort.
settingWomen residing in Norway, general population.
participantsOur analysis included 5032, 2468 and 1594 women from the Norwegian Women and Cancer study diagnosed with BC, CRC and LC, respectively, who responded to a questionnaire between 1996 and 2014. EXPOSURE MEASURES: HLI score measured prior to cancer diagnosis. The HLI combines physical activity level, body mass index, smoking behaviour, alcohol consumption and dietary habits. OUTCOME MEASURES: We estimated HRs and 95% CIs using Cox proportional hazard models for all-cause and site-specific cancer mortality.
resultsAfter median follow-up times of 9.8, 7.1 and 5.9 years for BC, CRC and LC cases, respectively, there were 912, 902 and 1094 all-cause deaths; and 509 BC deaths, 679 CRC deaths and 961 LC deaths. For women diagnosed with BC, a 1-point HLI score increment was associated with a 6% lower all-cause mortality rate (HR: 0.94, 95% CI: 0.92 to 0.97). The data were compatible with no association for the estimated 3% lower BC mortality rate (HR: 0.97, 95% CI: 0.94 to 1.00) among women diagnosed with BC, and for the estimated 3% lower all-cause (HR: 0.97, 95% CI: 0.95 to 1.00) and 2% lower CRC mortality rates (HR: 0.98, 95% CI: 0.95 to 1.01) among women diagnosed with CRC. For women diagnosed with LC, prediagnostic HLI score was not associated with all-cause (HR: 1.00, 95% CI: 0.98 to 1.02) or LC mortality rates (HR: 1.00, 95% CI: 0.98 to 1.03).
conclusionsWe observed that a higher HLI score measured before cancer diagnosis was associated with lower all-cause and, possibly, lower BC mortality among Norwegian women diagnosed with BC; and a possible lower all-cause and CRC mortality among those diagnosed with CRC. Smoking was likely responsible for the observed associations.
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