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Table 5 Population attributable risks (PARs) according to individual lifestyle factors and combined 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

  Colon cancer Rectal cancer Colorectal cancer
  Cases, numberb %PAR (95% CI) Cases, numberb %PAR (95% CI) Cases, numberb %PAR (95% CI)
All participants       
Individual lifestyle factors c :       
Overweight and obesity 1,231 10 (6 to 13) 671 3 (-1 to 7) 1,902 8 (5 to 11)
Physical activity 1,144 6 (2 to 10) 648 NA 1,792 3 (0 to 6)
Smoking 550 2 (-3 to 4) 378 4 (1 to 7) 928 4 (1 to 6)
Alcohol consumption 695 2 (-1 to 4) 462 6 (2 to 9) 1,157 4 (1 to 6)
Diet quality 1,084 5 (2 to 8) 629 5 (-2 to 9) 1,713 5 (2 to 7)
HLI <5 d 2,160 17 (6 to 26) 1,266 13 (-4 to 27) 3,426 16 (7 to 24)
Men       
Individual lifestyle factors c :       
Overweight and obesity 602 15 (8 to 21) 393 5 (-2 to 11) 995 10 (5 to 14)
Physical activity 515 4 (-2 to 9) 360 5 (-7 to 15) 875 3 (-1 to 6)
Smoking 289 1 (-2 to 4) 223 3 (-2 to 8) 512 4 (-3 to 11)
Alcohol consumption 377 5 (1 to 9) 287 12 (5 to 18) 664 7 (3 to 10)
Diet quality 451 4 (-1 to 9) 342 12 (3 to 20) 793 6 (1 to 10)
HLI <5 d 946 13 (-8 to 28) 686 36 (13 to 53) 1,632 22 (7 to 34)
Women       
Individual lifestyle factors c :       
Overweight and obesity 629 7 (2 to 11) 278 2 (-5 to 8) 907 5 (1 to 9)
Physical activity 629 7 (1 to 12) 288 NA 917 2 (-2 to 6)
Smoking 261 11 (-27 to 37) 155 2 (-2 to 6) 416 1 (-1 to 2)
Alcohol consumption 318 NA 175 2 (-2 to 6) 493 1 (-3 to 4)
Diet quality 633 6 (1 to10) 287 NA 920 2 (0 to 4)
HLI <5 d 1,214 20 (6 to 32) 580 NA 1,794 11 (1 to 21)
  1. aThe HLI (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. bThe number of cases denotes those cases without the healthy lifestyle factor or not adhering to all five healthy lifestyle factors. cPAR according to each of the individual lifestyle factors, stratified by EPIC study centre, and adjusted for age, sex, education (none, primary school, technical/professional school) and mutually adjusted for the other lifestyle factors, including overweight and obesity, physical activity, smoking, alcohol consumption and diet quality (binary variables). PARs are calculated by reversing the coding of the protective factors and taking into account the relative proportion of exposed cases based on the formula from Miettinen et al. [31]. The 95% CIs are calculated based on the formula of Whittemore et al. [33]. The PARs denote the percentage of colorectal cancer cases in the population that are attributable to the non-adherence to the particular healthy lifestyle factor. dPAR, stratified by EPIC study centre, and adjusted for age at study recruitment, sex and educational status (none, primary school, technical/professional school). The PAR denotes the percentage of colorectal cancer cases in the population that are attributable to the non-adherence to five healthy lifestyle behaviours. PARs are calculated based on a formula from Bruzzi et al. [32]. The 95% CIs are calculated based on the formula of Whittemore et al. [33]. Note: No meaningful PAR estimates were obtained for the associations of : physical activity and rectal cancer in all participants; alcohol consumption and colon cancer in women; as well as for physical activity and diet quality and rectal cancer in women, because the estimated hazard ratios for these individual factors in women were close to 1 (Please, see Table 3). CI, confidence interval; EPIC, European Prospective Investigation into Cancer and Nutrition.