Five Healthy Behaviors That May Lower Colorectal Cancer Risk

Adopting a combination of five healthy behaviors is linked to a reduction in the risk of developing colorectal cancer, according to the results of a large cohort study from Europe. The impact was greater in men compared with women. The results of the study were published in BMC Medicine.

Compared with the study subjects who adopted one or none of the healthy lifestyle behaviors, those who adopted all five had a 37% lower risk of developing colorectal cancer. For those who adopted two, three, or four of the lifestyle factors, the decreases in risk were 13%, 21%, and 34%, respectively (P < .0001).

“Our data confirmed that, with an increasing number of healthy lifestyle behaviors, the risk that a person will have of developing bowel cancer decreases,” said study author Krasimira Aleksandrova, PhD, of the department of epidemiology at the German Institute of Human Nutrition in Berlin.

The researchers wanted to test whether the combination of five modifiable lifestyle factors-healthy weight, physical activity, nonsmoking, limited alcohol consumption, and healthy diet-could mitigate the risk of colorectal cancer. They collected data on 347,237 subjects, age 25 to 70, within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study subjects were followed for 12 years and provided dietary and lifestyle data. After the follow-up period, 3,759 were diagnosed with colorectal cancer. The median age of the participants was 51.8.

The study found that adopting at least two of the lifestyle changes could decrease the relative risk of colorectal cancer, after correcting for education, sex, and age of the participants.

A total of 59% of the subjects had a body mass index and waist circumference within the recommended healthy range; 52% had a high level of physical activity; 76% were nonsmokers (63% were never-smokers); and 60% had a healthy diet as evaluated by the dietary quality index, which includes a diet high in vegetables, fruit, fish, yogurt, nuts, seeds, high-fiber foods, and foods low in processed and red meat.

Colorectal cancer is the third most common cancer among both men and women in the United States, according to the American Cancer Society, which predicts that about 136,830 new cases will be diagnosed in 2014. Over a lifetime, the risk of colorectal cancer is about 5%. Colorectal cancer has been linked to a Western diet, including high red and processed meat consumption, as well as higher alcohol consumption and smoking. However, it is still not clear which healthy lifestyle factors have the greatest impact on colorectal cancer risk, and for which individuals.

The current analysis showed that the combination of three of the factors-healthy weight, nonsmoking, and healthy diet-was linked to as low a risk of colorectal cancer as was the combination of all five factors. But, because of the low prevalence of this combination, additional studies are needed to assess the lifestyle patterns that mitigate colorectal cancer risk, including additional factors such as non-steroidal anti-inflammatory drug use and use of dietary supplements like vitamin D and calcium.

“These data provide additional incentive to individuals, medical professionals, and public health authorities to invest in healthy lifestyle initiatives. Each person can contribute a lot to avoid cancer, the more healthy lifestyle changes, the better,” said Aleksandrova.