Composite Score of Healthy Lifestyle Factors and Risk of Hepatocellular Carcinoma: Findings from a Prospective Cohort Study
Menée en Chine auprès de 63 257 personnes (durée moyenne de suivi : 17,7 ans), cette étude analyse l'association entre le risque de carcinome hépatocellulaire (561 cas) et des facteurs de risque modifiables évalués à l'aide d'un système de score (indice de masse corporelle, consommation d'alcool, tabagisme, régime alimentaire et durée du sommeil)
Background: While the associations between individual lifestyle factors and risk of hepatocellular carcinoma (HCC) have been previously described, their combined impact on HCC risk is unknown.
Methods: The association of a composite score of healthy lifestyle factors, including body mass index, alcohol consumption, cigarette smoking, alternative Mediterranean diet, and sleep duration, and HCC risk was examined in the Singapore Chinese Health Study, an on-going prospective cohort study of 63,257 Chinese. Cox proportional hazard regression method was used to estimate hazard ratio (HR) and its 95% confidence interval (CI). Conditional logistic regression method was used to evaluate this composite lifestyle score-HCC risk association among a subset of individuals who tested negative for hepatitis B surface antigen (HBsAg) and anti-hepatitis C antibody.
Results: After a mean follow-up of 17.7 years, 561 participants developed HCC. Individuals with higher composite scores representing healthier lifestyles (range 0-8) were at significantly lower risk of HCC. Compared to the lowest composite score category (0-4), the HRs (95% CIs) for the composite scores of 5, 6, 7, and 8 were 0.67 (0.62-0.85), 0.61 (0.48-0.77), 0.49 (0.37-0.65), and 0.13 (0.06-0.30), respectively (Ptrend<0.0001). A similar inverse association was observed in participants with negative HBsAg and anti-HCV negative serology (HR=0.38, 95% CI: 0.19-0.79; for the highest versus the lowest category of the composite scores (Ptrend=0.001).
Conclusion: Healthy lifestyles protects against HCC development, especially for individuals without hepatitis B virus and hepatitis C infections.
Impact: Our current study highlight the importance of a comprehensive lifestyle modification strategy for HCC primary prevention.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2019