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dc.contributor.authorNaudin, Sabine
dc.contributor.authorMargalef, Marta Solans
dc.contributor.authorSaberi Hosnijeh, Fatemeh
dc.contributor.authorNieters, Alexandra
dc.contributor.authorKyrø, Cecilie
dc.contributor.authorTjønneland, Anne
dc.contributor.authorDahm, Christina C.
dc.contributor.authorOvervad, Kim
dc.contributor.authorMahamat-Saleh, Yahya
dc.contributor.authorBesson, Caroline
dc.contributor.authorBoutron-Ruault, Marie-Christine
dc.contributor.authorKühn, Tilman
dc.contributor.authorCanzian, Federico
dc.contributor.authorSchulze, Matthias B.
dc.contributor.authorPeppa, Eleni
dc.contributor.authorKarakatsani, Anna
dc.contributor.authorTrichopoulou, Antonia
dc.contributor.authorSieri, Sabina
dc.contributor.authorMasala, Giovana
dc.contributor.authorPanico, Salvatore
dc.contributor.authorTumino, Rosario
dc.contributor.authorRicceri, Fulvio
dc.contributor.authorChen, Sairah Lai Fa
dc.contributor.authorBarroso, Leila L.
dc.contributor.authorHuerta, José María
dc.contributor.authorSánchez, Maria-Jose
dc.contributor.authorArdanaz, Eva
dc.contributor.authorMenéndez, Virginia
dc.contributor.authorExezarreta, Pilar Amiano
dc.contributor.authorSpaeth, Florentin
dc.contributor.authorJerkeman, Mats
dc.contributor.authorJirstom, Karin
dc.contributor.authorSchmidt, Julie A.
dc.contributor.authorAune, Dagfinn
dc.contributor.authorWeiderpass, Elisabete
dc.contributor.authorRiboli, Elio
dc.contributor.authorVermeulen, Roel
dc.contributor.authorCasabonne, Delphine
dc.contributor.authorGunter, Marc
dc.contributor.authorBrennan, Paul
dc.contributor.authorFerrari, Pietro
dc.date.accessioned2021-04-14T11:58:45Z
dc.date.available2021-04-14T11:58:45Z
dc.date.issued2020-03-16
dc.description.abstractLimited evidence exists on the role of modifiable lifestyle factors on the risk of lymphoma. In this work, the associations between adherence to healthy lifestyles and risks of Hodgkin lymphoma (HL) and non‐Hodgkin lymphoma (NHL) were evaluated in a large‐scale European prospective cohort. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), 2,999 incident lymphoma cases (132 HL and 2,746 NHL) were diagnosed among 453,808 participants after 15 years (median) of follow‐up. The healthy lifestyle index (HLI) score combined information on smoking, alcohol intake, diet, physical activity and BMI, with large values of HLI expressing adherence to healthy behavior. Cox proportional hazards models were used to estimate lymphoma hazard ratios (HR) and 95% confidence interval (CI). Sensitivity analyses were conducted by excluding, in turn, each lifestyle factor from the HLI score. The HLI was inversely associated with HL, with HR for a 1‐standard deviation (SD) increment in the score equal to 0.78 (95% CI: 0.66, 0.94). Sensitivity analyses showed that the association was mainly driven by smoking and marginally by diet. NHL risk was not associated with the HLI, with HRs for a 1‐SD increment equal to 0.99 (0.95, 1.03), with no evidence for heterogeneity in the association across NHL subtypes. In the EPIC study, adherence to healthy lifestyles was not associated with overall lymphoma or NHL risk, while an inverse association was observed for HL, although this was largely attributable to smoking. These findings suggest a limited role of lifestyle factors in the etiology of lymphoma subtypes.en_US
dc.descriptionThis is the peer reviewed version of the following article: Naudin, S., Margalef, M.S., Hosnijeh, F.S., Nieters, A., Kyrø, C. Tjønneland, A. ... Ferrari, P. (2020) Healthy lifestyle and the risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition study. <i>International Journal of Cancer, 147</i>(6):1649-1656, which has been published in final form at <a href=https://doi.org/10.1002/ijc.32977>https://doi.org/10.1002/ijc.32977</a>. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.en_US
dc.identifier.citationNaudin, S., Margalef, M.S., Hosnijeh, F.S., Nieters, A., Kyrø, C. Tjønneland, A. ... Ferrari, P. (2020) Healthy lifestyle and the risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition study. <i>International Journal of Cancer, 147</i>(6):1649-1656en_US
dc.identifier.cristinIDFRIDAID 1819654
dc.identifier.doi10.1002/ijc.32977
dc.identifier.issn0020-7136
dc.identifier.issn1097-0215
dc.identifier.urihttps://hdl.handle.net/10037/20878
dc.language.isoengen_US
dc.publisherWileyen_US
dc.relation.journalInternational Journal of Cancer
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright © 1999-2021 John Wiley & Sons, Inc. All rights reserveden_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801en_US
dc.titleHealthy lifestyle and the risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition studyen_US
dc.type.versionacceptedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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