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Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study

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dc.contributor.author Freisling, Heinz
dc.contributor.author Viallon, Vivian
dc.contributor.author Lennon, Hannah
dc.contributor.author Bagnardi, Vincenzo
dc.contributor.author Ricci, Cristian
dc.contributor.author Butterworth, Adam-S
dc.contributor.author Sweeting, Michael
dc.contributor.author Muller, David
dc.contributor.author Romieu, Isabelle
dc.contributor.author Bazelle, Pauline
dc.contributor.author Kvaskoff, Marina
dc.contributor.author Arveux, Patrick
dc.contributor.author Severi, Gianluca
dc.contributor.author Bamia, Christina
dc.contributor.author Kuehn, Tilman
dc.contributor.author Kaaks, Rudolf
dc.contributor.author Bergmann, Manuela
dc.contributor.author Boeing, Heiner
dc.contributor.author Tjonneland, Anne
dc.contributor.author Olsen, Anja
dc.contributor.author Overvad, Kim
dc.contributor.author Dahm, Christina-C
dc.contributor.author Menéndez, Virginia
dc.contributor.author Agudo, Antonio
dc.contributor.author Sánchez, María-José
dc.contributor.author Amiano, Pilar
dc.contributor.author Santiuste, Carmen
dc.contributor.author Barricarte-Gurrea, Aurelio
dc.contributor.author Tong, Tammy-Y-N
dc.contributor.author Schmidt, Julie-A
dc.contributor.author Tzoulaki, Ioanna
dc.contributor.author Tsilidis, Konstantinos-K
dc.contributor.author Ward, Heather
dc.contributor.author Palli, Domenico
dc.contributor.author Agnoli, Claudia
dc.contributor.author Tumino, Rosario
dc.contributor.author Ricceri, Fulvio
dc.contributor.author Panico, Salvatore
dc.contributor.author Picavet, H-Susan-J
dc.contributor.author Bakker, Marije
dc.contributor.author Monninkhof, Evelyn
dc.contributor.author Nilsson, Peter
dc.contributor.author Manjer, Jonas
dc.contributor.author Rolandsson, Olov
dc.contributor.author Thysell, Elin
dc.contributor.author Weiderpass, Elisabete
dc.contributor.author Jenab, Mazda
dc.contributor.author Riboli, Elio
dc.contributor.author Vineis, Paolo
dc.contributor.author Danesh, John
dc.contributor.author Wareham, Nick-J
dc.contributor.author Gunter, Marc-J
dc.contributor.author Ferrari, Pietro
dc.date.accessioned 2025-05-09T10:02:49Z
dc.date.available 2025-05-09T10:02:49Z
dc.date.issued 2020-01-10
dc.identifier.citation Freisling H, Viallon V, Lennon H, Bagnardi V, Ricci C, Butterworth AS, et al. Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study. BMC Med. 10 de enero de 2020;18(1):5.
dc.identifier.issn 1741-7015
dc.identifier.uri https://sms.carm.es/ricsmur/handle/123456789/18955
dc.description.abstract BACKGROUND: Although lifestyle factors have been studied in relation to individual non-communicable diseases (NCDs), their association with development of a subsequent NCD, defined as multimorbidity, has been scarcely investigated. The aim of this study was to investigate associations between five lifestyle factors and incident multimorbidity of cancer and cardiometabolic diseases. METHODS: In this prospective cohort study, 291,778 participants (64% women) from seven European countries, mostly aged 43 to 58 years and free of cancer, cardiovascular disease (CVD), and type 2 diabetes (T2D) at recruitment, were included. Incident multimorbidity of cancer and cardiometabolic diseases was defined as developing subsequently two diseases including first cancer at any site, CVD, and T2D in an individual. Multi-state modelling based on Cox regression was used to compute hazard ratios (HR) and 95% confidence intervals (95% CI) of developing cancer, CVD, or T2D, and subsequent transitions to multimorbidity, in relation to body mass index (BMI), smoking status, alcohol intake, physical activity, adherence to the Mediterranean diet, and their combination as a healthy lifestyle index (HLI) score. Cumulative incidence functions (CIFs) were estimated to compute 10-year absolute risks for transitions from healthy to cancer at any site, CVD (both fatal and non-fatal), or T2D, and to subsequent multimorbidity after each of the three NCDs. RESULTS: During a median follow-up of 11 years, 1910 men and 1334 women developed multimorbidity of cancer and cardiometabolic diseases. A higher HLI, reflecting healthy lifestyles, was strongly inversely associated with multimorbidity, with hazard ratios per 3-unit increment of 0.75 (95% CI, 0.71 to 0.81), 0.84 (0.79 to 0.90), and 0.82 (0.77 to 0.88) after cancer, CVD, and T2D, respectively. After T2D, the 10-year absolute risks of multimorbidity were 40% and 25% for men and women, respectively, with unhealthy lifestyle, and 30% and 18% for men and women with healthy lifestyles. CONCLUSION: Pre-diagnostic healthy lifestyle behaviours were strongly inversely associated with the risk of cancer and cardiometabolic diseases, and with the prognosis of these diseases by reducing risk of multimorbidity.
dc.language.iso eng
dc.publisher BMC
dc.rights Atribución-NoComercial-SinDerivadas 4.0 España
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es *
dc.subject.mesh Adult
dc.subject.mesh Alcohol Drinking
dc.subject.mesh Body Mass Index
dc.subject.mesh Cardiovascular Diseases/complications/epidemiology/etiology
dc.subject.mesh Cohort Studies
dc.subject.mesh Diabetes Mellitus, Type 2/complications
dc.subject.mesh Female
dc.subject.mesh Humans
dc.subject.mesh Incidence
dc.subject.mesh Life Style
dc.subject.mesh Male
dc.subject.mesh Middle Aged
dc.subject.mesh Multimorbidity
dc.subject.mesh Neoplasms/complications/epidemiology/etiology
dc.subject.mesh Proportional Hazards Models
dc.subject.mesh Prospective Studies
dc.subject.mesh Risk Factors
dc.subject.mesh Risk Reduction Behavior
dc.title Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study
dc.type info:eu-repo/semantics/article
dc.identifier.pmid 31918762
dc.relation.publisherversion https://dx.doi.org/10.1186/s12916-019-1474-7
dc.type.version info:eu-repo/semantics/publishedVersion
dc.identifier.doi 10.1186/s12916-019-1474-7
dc.journal.title BMC medicine


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