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Open Access 02-10-2023 | Colorectal Cancer | Original Paper

Combined associations of a healthy lifestyle and body mass index with colorectal cancer recurrence and survival: a cohort study

Authors: Shabane Barot, Petri Rantanen, Caroline Nordenvall, Ulrik Lindforss, Åsa Hallqvist Everhov, Susanna C. Larsson, Annika Lindblom, Annelie Liljegren

Published in: Cancer Causes & Control | Issue 2/2024

Abstract

Purpose

Colorectal cancer (CRC) risk is associated with modifiable lifestyle factors including smoking, physical inactivity, Western diet, and excess body weight. The impact of lifestyle factors on survival is less known. A cohort study was conducted to investigate the combined effects of a healthy lifestyle and body mass index on prognosis following CRC diagnosis.

Methods

Treatment and follow-up data were collected from the patient files of 1098 participants from the Colorectal cancer low-risk study cohort including stage I-III CRC patients. A healthy lifestyle and BMI (HL) score was computed using self-reported data on smoking status, physical activity, adherence to a Mediterranean diet pattern, and BMI, and divided into four categories ranging from least to most healthy. Survival analyses were performed to assess recurrence-free survival and overall survival across categories of exposure, using the Kaplan–Meier method and Cox proportional hazards models adjusted for age, sex, and educational level.

Results

Among 1098 participants with stage I-III CRC, 233 (21.2%) had an HL score of 0–1 (least healthy), 354 (32.2%) HL score of 2, 357 (32.5%) HL score of 3 and 154 (14.0) HL score 4 (most healthy). Patients with the healthiest lifestyle (HL score 4) compared to the least healthy (HL score 0–1) had an improved recurrence-free survival (HL 4 vs HL 0–1, HRadj 0.51 (95% CI 0.31–0.83) and overall survival (HL 4 vs HL 0–1, HRadj 0.52 (95% CI 0.38–0.70).

Conclusion

Adherence to a healthy lifestyle may increase the recurrence-free and overall survival of patients with stage I–III CRC.

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Title: Combined associations of a healthy lifestyle and body mass index with colorectal cancer recurrence and survival: a cohort study
Authors: Shabane Barot
Petri Rantanen
Caroline Nordenvall
Ulrik Lindforss
Åsa Hallqvist Everhov
Susanna C. Larsson
Annika Lindblom
Annelie Liljegren
Publication date: 02-10-2023
Publisher: Springer International Publishing
Keywords: Colorectal Cancer
Colorectal Cancer
Published in: Cancer Causes & Control / Issue 2/2024
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-023-01802-y

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