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Combined lifestyle factors, incident cancer, and cancer mortality: a systematic review and meta-analysis of prospective cohort studies
Open accessAbstract
BACKGROUND: Cancer poses a huge disease burden, which could be reduced by adopting healthy lifestyles mainly composed of healthy diet, body weight, physical activity, limited alcohol consumption, and avoidance of smoking. However, no systematic review has summarised the relations of combined lifestyle factors with cancer morbidity and mortality. METHODS: EMBASE and PubMed were searched up to April 2019. Cohort studies investigating the association of combined lifestyle factors with risks of incident cancer and cancer mortality were selected. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity and publication bias tests were conducted. RESULTS: The HRs (95% CIs) comparing individuals with the healthiest versus the least healthy lifestyles were 0.71 (0.66-0.76; 16 studies with 1.9 million participants) for incident cancer and 0.48 (0.42-0.54; 30 studies with 1.8 million participants) for cancer mortality. Adopting the healthiest lifestyles was also associated with 17 to 58% lower risks of bladder, breast, colon, endometrial, oesophageal, kidney, liver, lung, rectal, and gastric cancer. The relations were largely consistent and significant among participants with different characteristics in the subgroup analyses. CONCLUSIONS: Adopting healthy lifestyles is associated with substantial risk reduction in cancer morbidity and mortality, and thus should be given priority for cancer prevention.
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A healthy lifestyle has been associated with a reduced risk of HCC.
“Altogether, a healthy lifestyle has been associated with a reduced risk of HCC.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [117]
The Results section on site-specific cancers reports that the healthiest lifestyles were associated with lower liver-cancer risk than the least healthy lifestyles. It does not identify hepatocellular carcinoma (HCC) specifically, so the HCC-specific claim is more precise than the evidence in our copy. (LLM, conf=0.84)
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Metadata
- Authors
- Zhang, Y.-B., Pan, X.-F., Chen, J., Cao, A., Zhang, Y.-G., Xia, L., Wang, J., Li, H., Liu, G., & Pan, A.
- Affiliations
- Huazhong University of Science and Technology (CN)
- Corresponding author
- Pan, An
- Venue
- British Journal of Cancer
- Published
- 2020-02-10
- Volume
- 122
- Issue
- 7
- Pages
- 1085-1093
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC7109112
- OpenAlex
- W3005522002
- Cited by
- 280
- References
- 49
- Citations by year
- 2026: 34 · 2025: 47 · 2024: 68 · 2023: 52 · 2022: 42 · 2021: 27 · 2020: 9
- FWCI
- 3.49
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- British Journal of Cancer (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Washington University in St. Louis
- University of Pittsburgh
- York University
- University of Bristol
- National Natural Science Foundation of China (81773517, 81930124, 2017YFC0907504)
- China Postdoctoral Science Foundation (176596)
- National Key Research and Development Program of China (2017YFC0907504, 2018CFA033, 81930124)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- healthy lifestyle, incident cancer, cancer mortality, cancer prevention, diet, body weight, physical activity, alcohol consumption, smoking, bladder cancer, breast cancer, colon cancer, endometrial cancer, esophageal cancer, kidney cancer, liver cancer, lung cancer, rectal cancer, gastric cancer
- MeSH terms
- Healthy Lifestyle, Adult, Aged, Female, Humans, Male, Middle Aged, Neoplasms, Prospective Studies, Risk Factors, Cohort Studies, Incidence
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