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Table 4 Hazard ratios (HRs) of colorectal cancer according to the Healthy Lifestyle Index (HLI) a , the EPIC cohort (1992 to 2010)

From: Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study

HLI Colon cancer Rectal cancer Colorectal cancer
  Cases, number HRb(95% CI) Cases, number HRb(95% CI) Cases, number HRb(95% CI)
All participants       
0 or 1 216 1 (Reference) 133 1 (Reference) 349 1 (Reference)
2 526 0.85 (0.72 to 0.99) 326 0.90 (0.74 to 1.11) 852 0.87 (0.76 to 0.98)
3 816 0.78 (0.67 to 0.91) 459 0.80 (0.66 to 0.97) 1275 0.79 (0.70 to 0.89)
4 602 0.64 (0.54 to 0.75) 348 0.70 (0.57 to 0.85) 950 0.66 (0.58 to 0.75)
5 209 0.61 (0.50 to 0.74) 124 0.68 (0.53 to 0.88) 333 0.63 (0.54 to 0.74)
P-trend   <0.0001   <0.0001   <0.0001
Per one point increase   0.87 (0.84 to 0.91)   0.90 (0.85 to 0.94)   0.88 (0.86 to 0.92)
P-valuec   <0.0001   <0.0001   <0.0001
Men       
0 or 1 135 1 (Reference) 94 1 (Reference) 229 1 (Reference)
2 266 0.80 (0.65 to 0.98) 196 0.87 (0.67 to 1.10) 462 0.83 (0.71 to 0.97)
3 330 0.70 (0.57 to 0.85) 236 0.75 (0.59 to 0.95) 566 0.72 (0.62 to 0.84)
4 215 0.59 (0.46 to 0.73) 160 0.66 (0.51 to 0.85) 375 0.62 (0.52 to 0.73)
5 83 0.61 (0.46 to 0.81) 42 0.47 (0.32 to 0.68) 125 0.56 (0.44 to 0.69)
P-trend   <0.0001   <0.0001   <0.0001
Per one point increase   0.86 (0.82 to 0.91)   0.86 (0.80 to 0.91)   0.87 (0.83 to 0.90)
P-valuec   <0.0001   <0.0001   <0.0001
Women       
0 or 1 81 1 (Reference) 39 1 (Reference) 120 1 (Reference)
2 260 0.93 (0.73 to 1.20) 130 1.03 (0.72 to 1.48) 390 0.97 (0.78 to 1.18)
3 486 0.91 (0.71 to 1.14) 223 0.96 (0.68 to 1.36) 709 0.92 (0.76 to 1.12)
4 387 0.72 (0.56 to 0.92) 188 0.84 (0.59 to 1.19) 575 0.76 (0.62 to 0.93)
5 126 0.65 (0.48 to 0.86) 82 1.01 (0.68 to 1.49) 208 0.76 (0.60 to 0.95)
P-trendc   <0.0001   0.35   <0.0001
Per one point increase   0.88 (0.84 to 0.93)   0.97 (0.99 to 1.04)   0.91 (0.87 to 0.95)
P-value   <0.0001   0.35   <0.0001
  1. aHealthy lifestyle index (range 0 to 5 points) is calculated by summing the binary lifestyle factor variables (0,1) including overweight and obesity, physical activity, smoking, alcohol consumption and diet quality. Participants received one point if they had any of the following behaviours: healthy weight, physically active, non-smokers or former smokers, limited alcohol consumption or healthy diet quality. bMultivariable model stratified by EPIC study centre and adjusted for age at study recruitment, sex and educational status (none, primary school, technical/professional school/not specified). c P-value for the linear trend was calculated using the Wald test treating the index as a continuous variable. Note: P-interaction by sex: 0.40, for colon cancer; 0.008 for rectal cancer; 0.03 for colorectal cancer. P for interaction is assessed using the likelihood ratio test by generating a cross-product term between HLI and sex in the multivariable model. CI, confidence interval; EPIC, European Prospective Investigation into Cancer and Health; HR, hazard ratio.