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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2021.1031    [Accepted]
Adherence to Cancer Prevention Guidelines and Cancer Incidence and Mortality: A Population-Based Cohort Study
Jin-Kyoung Oh1,2 , Minji Han1, Byungmi Kim1, Eun Young Park1
1Division of Cancer Prevention, National Cancer Center, Goyang, Korea
2Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
Correspondence  Jin-Kyoung Oh ,Tel: 82-31-920-2921, Fax: 82-31-920-2759, Email: jkoh@ncc.re.kr
Received: September 14, 2021;  Accepted: March 21, 2022.  Published online: March 22, 2022.
This study aimed to estimate the risk of cancer incidence and mortality according to adherence to lifestyle-related cancer prevention guidelines.
Materials and Methods
Men and women who participated in the general health screening program in 2002 and 2003 provided by the National Health Insurance Service were included (n=8,325,492). Self-reported smoking, alcohol consumption, and physical activity habits and directly measured body mass index were collected. The participants were followed up until the date of cancer onset or death or 31 December 2018. The Cox proportional hazard model was used to evaluate the hazard ratio (HR) for cancer incidence and mortality according to different combinations of lifestyle behaviors.
Only 6% of men and 15% of women engaged in healthy behavior at baseline, such as not smoking, not drinking alcohol, being moderately or highly physically active, and within a normal body mass index range. Compared to the best combination of healthy lifestyle behaviors, the weak and moderate associations with increased all cancer incidence (HR < 1.7) and mortality (HR < 2.5) were observed in those with heavy alcohol consumption and in former or current smokers. HRs of cancer mortality were significantly increased among current smokers in most combinations.
Compared to full adherence to cancer prevention recommendations, unhealthy behaviors increase cancer risk. As few people meet these recommendations, there is a great opportunity for cancer prevention.
Key words: Neoplasms, Prevention, Smoking, Alcohol, Body mass index, Physical activity, Republic of Korea
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