A healthy lifestyle before diagnosis may improve bowel cancer survival

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The large European Prospective Investigation into Cancer and Nutrition (EPIC) study, published in BMC Medicine [1], analysed data from 520,000 men and women from 10 countries over six years. Of these men and women from the study, 3,292 were diagnosed with bowel cancer.

Lead researcher, Dora Romaguera, from Imperial College London wanted to investigate if the same healthy lifestyle choices that help prevent bowel cancer could also improve the survival rates of people diagnosed with the disease.

“Current advice given to cancer survivors about lifestyle is to follow the same lifestyle recommendations for cancer prevention. Based on results of our own previous work on the EPIC cohort on cancer prevention, we wanted to see if following these recommendations were associated with the survivability of bowel cancer,” she said.

The study participants completed questionnaires about their medical history, diet and lifestyle at the start of the study, while height and weight measurements were also taken.

The researchers developed a scoring-system based on body weight; physical activity; food and drinks that promote weight gain; plant foods; meat-based food; and alcoholic drinks. Women were also scored on whether or not they had breastfed. The greater the number of healthy behaviours a person had, the more highly they were scored.

Results indicated the higher the score, the lower the risk of death - a trend that was observed in both men and women.

Having a healthy weight and high consumption of plant foods had the strongest associations with survival.

There was also an association seen with women who breastfed and improved survival. While this has been observed for breast cancer before, it is the first time it has been seen in bowel cancer and this initial finding is not sufficient evidence to show a protective effect of breast feeding on bowel cancer​.

But the study could not demonstrate what would happen if the healthy lifestyle habits were acquired after cancer diagnosis.

Tom Stansfeld, health information officer at Cancer Research UK, said: “It’s hard to know for sure whether the lifestyle choices people made before being diagnosed with bowel cancer explain the small differences in survival that we see from this research. While healthy choices may have a positive impact on bowel cancer survival, there are many different factors that could affect a person’s lifestyle after a cancer diagnosis."

As with most types of cancer, the chance of survival depends on how advanced the disease is at the time of diagnosis.

"We know that drinking less alcohol, eating a healthy balanced diet, being a non-smoker, keeping to a healthy weight and being active can all help prevent bowel cancer from developing. But further research will be needed to uncover how these behaviours, both pre and post diagnosis, could improve survival,” said Stansfeld.

Reference

1. Romaguera D, Wark PA, et al. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study. BMC Medicine 2015. doi: 10.1186/s12916-015-0332-5
2. EPIC – European Prospective Investigation into Cancer and Nutrition

klíčová slova: European Prospective Investigation into Cancer and Nutrition, EPIC study, healthy lifestyle, bowel cancer survival