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BMC Cancer
Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Research

Genetic factors, adherence to healthy lifestyle behaviors, and risk of bladder cancer

Authors: Qiangsheng He, Siqing Wu, Ying Zhou, Yuchen Liu, Bin Xia, Wenjing Li, Jinyu Zhao, Ningning Mi, Peng Xie, Xiwen Qin, Jinqiu Yuan, Yihang Pan

Published in: BMC Cancer | Issue 1/2023

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Abstract

Background

Genetic and lifestyle factors both contribute to the pathogenesis of bladder cancer, but the extent to which the increased genetic risk can be mitigated by adhering to a healthy lifestyle remains unclear. We aimed to investigate the association of combined lifestyle factors with bladder cancer risk within genetic risk groups.

Methods

We conducted a prospective study of 375 998 unrelated participants of European ancestry with genotype and lifestyle data and free of cancer from the UK biobank. We generated a polygenic risk score (PRS) using 16 single nucleotide polymorphisms and a healthy lifestyle score based on body weight, smoking status, physical activity, and diet. Cox models were fitted to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of genetic and lifestyle factors on bladder cancer.

Results

During a median follow-up of 11.8 years, 880 participants developed bladder cancer. Compared with those with low PRS, participants with intermediate and high PRS had a higher risk of bladder cancer (HR 1.29, 95% CI 1.07–1.56; HR 1.63, 95% CI 1.32–2.02, respectively). An optimal lifestyle was associated with an approximately 50% lower risk of bladder cancer than a poor lifestyle across all genetic strata. Participants with a high genetic risk and a poor lifestyle had 3.6-fold elevated risk of bladder cancer compared with those with a low genetic risk and an optimal lifestyle (HR 3.63, 95% CI 2.23 –5.91).

Conclusions

Adhering to a healthy lifestyle could substantially reduce the bladder cancer risk across all genetic strata, even for high-genetic risk individuals. For all populations, adopting an intermediate lifestyle is more beneficial than a poor one, and adhering to an optimal lifestyle is the ideal effective strategy for bladder cancer prevention.
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Literature
1.
2.
Cumberbatch MGK, Jubber I, Black PC, Esperto F, Figueroa JD, Kamat AM, Kiemeney L, Lotan Y, Pang K, Silverman DT, et al. Epidemiology of bladder cancer: a systematic review and contemporary update of risk factors in 2018. Eur Urol. 2018;74(6):784–95.PubMed
3.
Figueroa JD, Ye Y, Siddiq A, Garcia-Closas M, Chatterjee N, Prokunina-Olsson L, Cortessis VK, Kooperberg C, Cussenot O, Benhamou S, et al. Genome-wide association study identifies multiple loci associated with bladder cancer risk. Hum Mol Genet. 2014;23(5):1387–98.PubMed
4.
Turati F, Edefonti V, Bosetti C, Ferraroni M, Malvezzi M, Franceschi S, Talamini R, Montella M, Levi F, Dal Maso L, et al. Family history of cancer and the risk of cancer: a network of case-control studies. Ann Oncol. 2013;24(10):2651–6.PubMed
5.
Mucci LA, Hjelmborg JB, Harris JR, Czene K, Havelick DJ, Scheike T, Graff RE, Holst K, Möller S, Unger RH, et al. Familial risk and heritability of cancer among twins in nordic countries. JAMA. 2016;315(1):68–76.PubMedPubMedCentral
6.
Figueroa JD, Middlebrooks CD, Banday AR, Ye Y, Garcia-Closas M, Chatterjee N, Koutros S, Kiemeney LA, Rafnar T, Bishop T, et al. Identification of a novel susceptibility locus at 13q34 and refinement of the 20p12.2 region as a multi-signal locus associated with bladder cancer risk in individuals of European ancestry. Human Mol Genet. 2016;25(6):1203–14.
7.
Jia G, Lu Y, Wen W, Long J, Liu Y, Tao R, Li B, Denny JC, Shu XO, Zheng W. Evaluating the utility of polygenic risk scores in identifying high-risk individuals for eight common cancers. JNCI Cancer Spectr. 2020;4(3):pkaa021.PubMedPubMedCentral
8.
Kachuri L, Graff RE, Smith-Byrne K, Meyers TJ, Rashkin SR, Ziv E, Witte JS, Johansson M. Pan-cancer analysis demonstrates that integrating polygenic risk scores with modifiable risk factors improves risk prediction. Nat Commun. 2020;11(1):6084.PubMedPubMedCentral
9.
Shi Z, Yu H, Wu Y, Lin X, Bao Q, Jia H, Perschon C, Duggan D, Helfand BT, Zheng SL, et al. Systematic evaluation of cancer-specific genetic risk score for 11 types of cancer in the cancer genome atlas and electronic medical records and genomics cohorts. Cancer Med. 2019;8(6):3196–205.PubMedPubMedCentral
10.
GBD 2019 Cancer Risk Factors Collaborators. The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022;400(10352):563–91.
11.
Al-Zalabani AH, Stewart KF, Wesselius A, Schols AM, Zeegers MP. Modifiable risk factors for the prevention of bladder cancer: a systematic review of meta-analyses. Eur J Epidemiol. 2016;31(9):811–51.PubMedPubMedCentral
12.
Acham M, Wesselius A, van Osch FHM, Yu EY, van den Brandt PA, White E, Adami HO, Weiderpass E, Brinkman M, Giles GG, et al. Intake of milk and other dairy products and the risk of bladder cancer: a pooled analysis of 13 cohort studies. Eur J Clin Nutr. 2020;74(1):28–35.PubMed
13.
Witlox WJA, van Osch FHM, Brinkman M, Jochems S, Goossens ME, Weiderpass E, White E, van den Brandt PA, Giles GG, Milne RL, et al. An inverse association between the Mediterranean diet and bladder cancer risk: a pooled analysis of 13 cohort studies. Eur J Nutr. 2020;59(1):287–96.PubMed
14.
Al-Zalabani AH, Wesselius A, Yi-Wen YuE, van den Brandt P, Grant EJ, White E, Skeie G, Liedberg F, Weiderpass E, Zeegers MP. Tea consumption and risk of bladder cancer in the Bladder Cancer Epidemiology and Nutritional Determinants (BLEND) Study: Pooled analysis of 12 international cohort studies. Clin Nutr. 2022;41(5):1122–30.PubMed
15.
Yu EY, Wesselius A, Mehrkanoon S, Goosens M, Brinkman M, van den Brandt P, Grant EJ, White E, Weiderpass E, Le Calvez-Kelm F, et al. Vegetable intake and the risk of bladder cancer in the BLadder Cancer Epidemiology and Nutritional Determinants (BLEND) international study. BMC Med. 2021;19(1):56.PubMedPubMedCentral
16.
Dianatinasab M, Wesselius A, Salehi-Abargouei A, Yu EYW, Brinkman M, Fararouei M, van den Brandt P, White E, Weiderpass E, Le Calvez-Kelm F, et al. Adherence to a Western dietary pattern and risk of bladder cancer: a pooled analysis of 13 cohort studies of the bladder cancer epidemiology and nutritional determinants international study. Int J Cancer. 2020;147(12):3394–403.PubMedPubMedCentral
17.
Yu EYW, Dai Y, Wesselius A, van Osch F, Brinkman M, van den Brandt P, Grant EJ, White E, Weiderpass E, Gunter M, et al. Coffee consumption and risk of bladder cancer: a pooled analysis of 501,604 participants from 12 cohort studies in the BLadder Cancer Epidemiology and Nutritional Determinants (BLEND) international study. Eur J Epidemiol. 2020;35(6):523–35.PubMed
18.
Zhu M, Wang T, Huang Y, Zhao X, Ding Y, Zhu M, Ji M, Wang C, Dai J, Yin R, et al. Genetic risk for overall cancer and the benefit of adherence to a healthy lifestyle. Can Res. 2021;81(17):4618–27.
19.
Carr PR, Weigl K, Jansen L, Walter V, Erben V, Chang-Claude J, Brenner H, Hoffmeister M. Healthy lifestyle factors associated with lower risk of colorectal cancer irrespective of genetic risk. Gastroenterology. 2018;155(6):1805-1815.e1805.PubMed
20.
Arthur RS, Wang T, Xue X, Kamensky V, Rohan TE. Genetic factors, adherence to healthy lifestyle behavior, and risk of invasive breast cancer among women in the UK Biobank. J Natl Cancer Inst. 2020;112(9):893–901.PubMedPubMedCentral
21.
Jin G, Lv J, Yang M, Wang M, Zhu M, Wang T, Yan C, Yu C, Ding Y, Li G, et al. Genetic risk, incident gastric cancer, and healthy lifestyle: a meta-analysis of genome-wide association studies and prospective cohort study. Lancet Oncol. 2020;21(10):1378–86.PubMed
22.
Zhang YB, Pan XF, Chen J, Cao A, Zhang YG, Xia L, Wang J, Li H, Liu G, Pan A. Combined lifestyle factors, incident cancer, and cancer mortality: a systematic review and meta-analysis of prospective cohort studies. Br J Cancer. 2020;122(7):1085–93.PubMedPubMedCentral
23.
Plym A, Zhang Y, Stopsack KH, Delcoigne B, Wiklund F, Haiman C, Kenfield SA, Kibel AS, Giovannucci E, Penney KL, et al. A healthy lifestyle in men at increased genetic risk for prostate cancer. Eur Urol. 2022;83(4):343–51.PubMedPubMedCentral
24.
Sudlow C, Gallacher J, Allen N, Beral V, Burton P, Danesh J, Downey P, Elliott P, Green J, Landray M. UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age. Plos med. 2015;12(3):e1001779.PubMedPubMedCentral
25.
Shams-White MM, Romaguera D, Mitrou P, Reedy J, Bender A, Brockton NT. Further guidance in implementing the standardized 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Score. Cancer Epidemiol Biomarkers Prev. 2020;29(5):889–94.PubMed
26.
27.
Bycroft C, Freeman C, Petkova D, Band G, Elliott LT, Sharp K, Motyer A, Vukcevic D, Delaneau O, O’Connell J, et al. The UK Biobank resource with deep phenotyping and genomic data. Nature. 2018;562(7726):203–9.PubMedPubMedCentral
28.
Graff RE, Cavazos TB, Thai KK, Kachuri L, Rashkin SR, Hoffman JD, Alexeeff SE, Blatchins M, Meyers TJ, Leong L, et al. Cross-cancer evaluation of polygenic risk scores for 16 cancer types in two large cohorts. Nat Commun. 2021;12(1):970.PubMedPubMedCentral
29.
Machiela MJ, Chanock SJ. LDlink: a web-based application for exploring population-specific haplotype structure and linking correlated alleles of possible functional variants. Bioinformatics (Oxford, England). 2015;31(21):3555–7.PubMed
30.
Collister JA, Liu X, Clifton L. Calculating Polygenic Risk Scores (PRS) in UK Biobank: a practical guide for epidemiologists. Front Genet. 2022;13:818574.PubMedPubMedCentral
31.
Altman DG, Andersen PK. Calculating the number needed to treat for trials where the outcome is time to an event. BMJ. 1999;319(7223):1492–5.PubMedPubMedCentral
32.
Khera AV, Emdin CA, Drake I, Natarajan P, Bick AG, Cook NR, Chasman DI, Baber U, Mehran R, Rader DJ, et al. Genetic risk, adherence to a healthy lifestyle, and coronary disease. N Engl J Med. 2016;375(24):2349–58.PubMedPubMedCentral
33.
Said MA, Verweij N, van der Harst P. Associations of combined genetic and lifestyle risks with incident cardiovascular disease and diabetes in the UK Biobank study. JAMA Cardiol. 2018;3(8):693–702.PubMedPubMedCentral
34.
Lourida I, Hannon E, Littlejohns TJ, Langa KM, Hyppönen E, Kuzma E, Llewellyn DJ. Association of lifestyle and genetic risk with incidence of dementia. JAMA. 2019;322(5):430–7.PubMedPubMedCentral
35.
Rutten-Jacobs LC, Larsson SC, Malik R, Rannikmäe K, Sudlow CL, Dichgans M, Markus HS, Traylor M. Genetic risk, incident stroke, and the benefits of adhering to a healthy lifestyle: cohort study of 306 473 UK Biobank participants. BMJ. 2018;363:k4168.PubMedPubMedCentral
36.
McKenzie F, Biessy C, Ferrari P, Freisling H, Rinaldi S, Chajès V, Dahm CC, Overvad K, Dossus L, Lagiou P, et al. Healthy lifestyle and risk of cancer in the european prospective investigation into cancer and nutrition cohort study. Medicine (Baltimore). 2016;95(16):e2850.PubMed
37.
Warren Andersen S, Blot WJ, Shu XO, Sonderman JS, Steinwandel MD, Hargreaves MK, Zheng W. Adherence to cancer prevention guidelines and cancer risk in low-income and African American populations. Cancer Epidemiol Biomarkers Prev. 2016;25(5):846–53.PubMed
38.
Lin J, Forman MR, Wang J, Grossman HB, Chen M, Dinney CP, Hawk ET, Wu X. Intake of red meat and heterocyclic amines, metabolic pathway genes and bladder cancer risk. Int J Cancer. 2012;131(8):1892–903.PubMedPubMedCentral
39.
Lin J, Kamat A, Gu J, Chen M, Dinney CP, Forman MR, Wu X. Dietary intake of vegetables and fruits and the modification effects of GSTM1 and NAT2 genotypes on bladder cancer risk. Cancer Epidemiol Biomarkers Prev. 2009;18(7):2090–7.PubMed
40.
Avirmed S, Khuanbai Y, Sanjaajamts A, Selenge B, Dagvadorj BU, Ohashi M. Modifying effect of smoking on GSTM1 and NAT2 in relation to the risk of bladder cancer in mongolian population: a case-control study. Asian Pacific J Cancer Prevent. 2021;22(8):2479–85.
41.
Leeming RC, Koutros S, Karagas MR, Baris D, Schwenn M, Johnson A, Zens MS, Schned AR, Rothman N, Silverman DT, et al. Diet quality, common genetic polymorphisms, and bladder cancer risk in a New England population-based study. Eur J Nutr. 2022;61(8):3905–13.PubMedPubMedCentral
42.
García-Closas R, García-Closas M, Kogevinas M, Malats N, Silverman D, Serra C, Tardón A, Carrato A, Castaño-Vinyals G, Dosemeci M, et al. Food, nutrient and heterocyclic amine intake and the risk of bladder cancer. Eur J Cancer. 2007;43(11):1731–40.PubMed
43.
Lin J, Wang J, Greisinger AJ, Grossman HB, Forman MR, Dinney CP, Hawk ET, Wu X. Energy balance, the PI3K-AKT-mTOR pathway genes, and the risk of bladder cancer. Cancer Prev Res (Phila). 2010;3(4):505–17.PubMed
44.
Choi J, Jia G, Wen W, Shu XO, Zheng W. Healthy lifestyles, genetic modifiers, and colorectal cancer risk: a prospective cohort study in the UK Biobank. Am J Clin Nutr. 2021;113(4):810–20.PubMedPubMedCentral
45.
Health UDo, Health HSJAUDo, Services H: Smoking cessation: a report of the Surgeon General. 2020.
46.
Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, Carty C, Chaput JP, Chastin S, Chou R, et al. World health organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451–62.PubMed
Metadata
Title
Genetic factors, adherence to healthy lifestyle behaviors, and risk of bladder cancer
Authors
Qiangsheng He
Siqing Wu
Ying Zhou
Yuchen Liu
Bin Xia
Wenjing Li
Jinyu Zhao
Ningning Mi
Peng Xie
Xiwen Qin
Jinqiu Yuan
Yihang Pan
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-11455-4

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