Lifestyle changes prevent bowel cancer

Lead author, Krasimira Aleksandrova, says: “These data provide additional incentive to individuals, medical professionals and public health authorities to invest in healthy lifestyle initiatives. Each person can contribute a lot to avoid cancer, the more healthy lifestyle changes, the better.”

Bowel cancer, also called colorectal cancer, is the second most common cancer in men and the third most common cancer in women worldwide, with 55% cases occurring in developed regions such as North America and Western Europe.

Previous studies have identified links between the cancer frequency rates and western lifestyles. However, most research has focused on isolated lifestyle behaviours, such as eating red meat, while little is known about the combined impact of lifestyle factors beyond their individual effects.

The research published in the open access journal BMC Medicine analysed the data of 347,237 men and women from 10 countries from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study using a healthy lifestyle index. Over the 12-year study period, 3,759 cases of bowel cancer were recorded.

The healthy lifestyle index was composed by the following lifestyle factors:

• a healthy weight;
• low abdominal fat;
• participating in regular physical activity;
• not smoking and limiting alcohol;
• a diet high in fruits, vegetables, fish, yoghurt, nuts and seeds, and foods rich in fibre, and low amounts of red and processed meat.

For each of the five behaviours, study subjects were assigned one point for having the healthy factor and zero for not having the healthy factor. These points were then summed to generate a cumulative score for each participant.

Aleksandrova notes: “Our data confirmed that with an increasing number of healthy lifestyle behaviours the risk that a person will have of developing bowel cancer decreases.”

The researchers found that the more healthy lifestyle factors the cohort adopted, the lower their risk of bowel cancer. Compared to people who had followed up to one healthy lifestyle behaviour, those who practised a combination of two, three, four and all the five healthy behaviours had a 13%, 21%, 34% and 37% lower risk of developing bowel cancer, respectively. The authors noted a difference between men and women.

According to Aleksandrova: “Estimates based on our study populations suggest that up to 22% of the cases in men and 11% of the cases in women would have been prevented if all five of the healthy lifestyle behaviours had been followed. Our results particularly demonstrate the potential for prevention in men who are at a higher risk of bowel cancer than women.”