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. 2020 Nov 25;10(1):20561.
doi: 10.1038/s41598-020-76294-w.

Combinations of modifiable lifestyle behaviours in relation to colorectal cancer risk in Alberta's Tomorrow Project

Dylan E O'Sullivan  1 , Amy Metcalfe  2   3   4 , Troy W R Hillier  1 , Will D King  1 , Sangmin Lee  2 , Joy Pader  5 , Darren R Brenner  6   7   8
Affiliations

Combinations of modifiable lifestyle behaviours in relation to colorectal cancer risk in Alberta's Tomorrow Project

Dylan E O'Sullivan et al. Sci Rep. .

Abstract

The objective of this study was to identify distinct clusters of individuals that exhibit unique patterns of modifiable lifestyle-related behaviours and to determine how these patterns are associated with the risk of developing colorectal cancer (CRC). The study consisted of 26,460 participants and 267 CRC cases from Alberta's Tomorrow Project. Exploratory latent class analysis of risk behaviours (obesity, physical inactivity, meat consumption, smoking, alcohol consumption, and fruit and vegetable consumption) and Cox proportional hazard models were utilized. Seven unique behavioural groups were identified, where the risk of CRC was 2.34 to 2.87 times greater for high risk groups compared to the low risk group. Sex-specific models identified higher risk groups among men (Hazard Ratios [HRs]: 3.15 to 3.89) than among women (HRs: 1.99 to 2.19). Targeting groups defined by clustering of behaviours could potentially lead to more effective prevention of CRC on a population level.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Latent class analysis of lifestyle-related colorectal cancer risk behaviours and the association of these classes with the risk of developing colorectal cancer. Panel A depicts the relative proportion of participants that belong in each category for each risk behaviour in each class. For each risk behaviour, the left is the low risk category and the right is the high risk category. Rows represent the latent classes and each column represents a category for a risk behaviour. Abbreviations: BMI = Body Mass Index, F & V = fruits and vegetables, PA = physical activity. Panel B depicts the risk (hazard ratios) of colorectal cancer for each class compared to the lowest risk class (class 2) adjusted for age, sex, ethnicity, household income, education, and family history of CRC.
Figure 2
Figure 2
Latent class analysis of lifestyle-related colorectal cancer risk behaviours among men and the association of these classes with the risk of developing colorectal cancer. Panel A depicts the relative proportion of participants that belong in each category for each risk behaviour and family history of colorectal cancer in each class. For each risk behaviour, the left is the low risk category and the right is the high risk category. Rows represent the latent classes and each column represents a category for a risk behaviour. Abbreviations: BMI = Body Mass Index, F & V = fruits and vegetables, Fam Hist = Family history of colorectal cancer, PA = physical activity. Panel B depicts the risk (hazard ratios) of colorectal cancer for each class compared to the lowest risk class (class 5) adjusted for age, ethnicity, household income, and education.
Figure 3
Figure 3
Latent class analysis of lifestyle-related colorectal cancer risk behaviours among women and the association of these classes with the risk of developing colorectal cancer. Panel A depicts the relative proportion of participants that belong in each category for each risk behaviour and family history of colorectal cancer in each class. For each risk behaviour, the left is the low risk category and the right is the high risk category. Rows represent the latent classes and each column represents a category for a risk behaviour. Abbreviations: BMI = Body Mass Index, F & V = fruits and vegetables, Fam Hist = Family history of colorectal cancer, PA = physical activity. Panel B depicts the risk (hazard ratios) of colorectal cancer for each class compared to the lowest risk class (class 2) adjusted for age, ethnicity, household income, and education.
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