Lifestyle after colorectal cancer diagnosis in relation to recurrence and all-cause mortality

BACKGROUND: An unhealthy lifestyle is associated with the risk of colorectal cancer (CRC), but it is unclear whether overall lifestyle after a CRC diagnosis is associated with risks of recurrence and mortality. OBJECTIVES: To examine associations between postdiagnosis lifestyle and changes in lifestyle after a CRC diagnosis with risks of CRC recurrence and all-cause mortality. METHODS: The study population included 1425 newly diagnosed, stage I-III CRC patients from 2 prospective cohort studies enrolled between 2010 and 2016. Lifestyle, including BMI, physical activity, diet, and alcohol intake, was assessed at diagnosis and at 6 months postdiagnosis. We assigned lifestyle scores based on concordance with 2 sets of cancer prevention guidelines-from the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and the American Cancer Society (ACS)-and national disease prevention guidelines. Higher scores indicate healthier lifestyles. We computed adjusted HRs and 95% CIs using Cox regression. RESULTS: We observed 164 recurrences during a 2.8-year median follow-up and 171 deaths during a 4.4-year median follow-up. No associations were observed for CRC recurrence. A lifestyle more consistent with the ACS recommendations was associated with a lower all-cause mortality risk (HR per +1 SD, 0.85; 95% CI: 0.73-0.995). The same tendency was observed for higher WCRF/AICR (HR, 0.92; 95% CI: 0.78-1.08) and national (HR, 0.90; 95% CI: 0.77-1.05) lifestyle scores, although these associations were statistically nonsignificant. Generally, no statistically significant associations were observed for BMI, physical activity, diet, or alcohol. Improving one's lifestyle after diagnosis (+1 SD) was associated with a lower all-cause mortality risk for the ACS (HR, 0.80; 95% CI: 0.67-0.96) and national (HR, 0.84; 95% CI: 0.70-0.999) scores, yet was statistically nonsignificant for the WCRF/AICR score (HR, 0.94; 95% CI: 0.78-1.13). CONCLUSIONS: A healthy lifestyle after CRC diagnosis and improvements therein were not associated with the risk of CRC recurrence, but were associated with a decreased all-cause mortality risk.

Bibliographic Details

Main Authors:	van Zutphen, Moniek, Boshuizen, Hendriek C., Kenkhuis, Marlou Floor, Wesselink, Evertine, Geijsen, Anne J.M.R., de Wilt, Johannes H.W., van Halteren, Henk K., Spillenaar Bilgen, Ernst Jan, Keulen, Eric T.P., Janssen-Heijnen, Maryska L.G., Breukink, Stéphanie O., Bours, Martijn J.L., Kok, Dieuwertje E., Winkels, Renate M., Weijenberg, Matty P., Kampman, Ellen, van Duijnhoven, Fränzel J.B.
Format:	Article/Letter to editor biblioteca
Language:	English
Subjects:	alcohol, body mass index, colorectal cancer, diet, lifestyle, physical activity, recurrence, survival,
Online Access:	https://research.wur.nl/en/publications/lifestyle-after-colorectal-cancer-diagnosis-in-relation-to-recurr
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