SNFGE SNFGE
 
Thématique :
- Cancer colorectal (CCR)
Originalité :
Très original
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Immédiatement
 
 
Nom du veilleur :
Docteur Roger FAROUX
Coup de coeur :
 
 
Gastroenterology
  2018/12  
 
  2018 Dec;155(6):1805-1815.e5.  
  doi: 10.1053/j.gastro.2018.08.044.  
 
  Healthy Lifestyle Factors Associated With Lower Risk of Colorectal Cancer Irrespective of Genetic Risk  
 
  Carr PR, Weigl K, Jansen L, Walter V, Erben V, Chang-Claude J, Brenner H, Hoffmeister M  
  https://www.ncbi.nlm.nih.gov/pubmed/30201362  
 
 

Abstract

BACKGROUND & AIMS:

The combined effects of healthy lifestyle factors on colorectal cancer (CRC) risk are unclear. We aimed to develop a healthy lifestyle score, to investigate the joint effects of modifiable lifestyle factors on reduction of CRC risk and determine whether associations differ with genetic risk.

METHODS:

We collected data from a large population-based case-control study in Germany and used multiple logistic regression analyses to examine associations between the healthy lifestyle score (derived from 5 modifiable lifestyle factors: smoking, alcohol consumption, diet, physical activity, and body fatness) and CRC risk. We created a genetic risk score, based on 53 risk variants, to investigate the association of the healthy lifestyle score and risk of CRC, stratified by genetic risk.

RESULTS:

We included 4092 patients with CRC and 3032 individuals without CRC (controls) in our analysis. In adjusted models, compared with participants with 0 or 1 healthy lifestyle factor, participants with 2 (odds ratio [OR] 0.85; 95% confidence interval [CI] 0.67-1.06), 3 (OR 0.62; 95% CI 0.50-0.77), 4 (OR 0.53; 95% CI 0.42-0.66), or 5 (OR 0.33; 95% CI 0.26-0.43) healthy lifestyle factors had increasingly lower risks of CRC (P trend <.0001). We found no differences among subgroups stratified by genetic risk score, history of colonoscopy, or family history of CRC. Overall, 45% of CRC cases (95% CI 34%-53%) could be attributed to nonadherence to all 5 healthy lifestyle behaviors.

CONCLUSIONS:

In a large population-based case-control study, we identified a combination of lifestyle factors that appears to reduce risk of CRC, regardless of the patient's genetic profile. These results reinforce the importance of primary prevention of CRC.

 
 
Question posée
 
Un mode de vie “sain” réduit-il le risque de cancer colorectal, de façon indépendante par rapport au risque génétique ?
 
Question posée
 
Oui. Dans cette étude cas témoin, les personnes ayant un score “de vie saine” favorable avait un risque réduit de cancer colorectal persistant après ajustement au risque génétique.
 
Commentaires

La prévention primaire portant ici sur 5 facteurs simples : tabac, alcool, régime alimentaire, activité physique, surpoids permettrait de réduire de 45% le risque de cancer colorectal. La prévention primaire, comme le dépistage reste un objectif de santé publique.

 
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