Table 3.

Association between the adherence to public health recommendations and the risk of any-site and site-specific cancer, E3N cohort (N = 64,732)

Health indexa categories
[0; 2][2.5; 3][3.5; 4][4.5; 5]Ptrend
All-site cancer (N = 6,938)
 All, number of cases (%)450 (6.48)1,554 (22.40)2,974 (42.87)1,960 (28.25)
  HR (95% CI)b1.00 (reference)0.88 (0.79–0.98)0.86 (0.78–0.95)0.81 (0.73–0.89)<0.001
Breast cancer (N = 3,483)
 Premenopausal, number of cases (%)47 (7.72)141 (23.15)268 (44.01)153 (25.12)
  HR (95% CI)c1.00 (reference)0.81 (0.59–1.13)0.90 (0.66–1.22)0.80 (0.58–1.12)0.288
 Postmenopausal, number of cases (%)169 (5.88)623 (21.68)1,284 (44.68)798 (27.76)
  HR (95% CI)d1.00 (reference)0.95 (0.80–1.12)0.99 (0.85–1.17)0.87 (0.74–1.03)0.016
Nonbasal skin cancer (N = 686)
 All, number of cases (%)26 (3.79)125 (18.22)283 (41.25)252 (36.74)
  HR (95% CI)b1.00 (reference)1.22 (0.80–1.87)1.40 (0.94–2.09)1.75 (1.17–2.62)<0.001
Colorectal cancer (N = 481)
 All, number of cases (%)33 (6.86)110 (22.87)207 (43.04)131 (27.23)
  HR (95% CI)b1.00 (reference)0.83 (0.56–1.22)0.76 (0.53–1.10)0.66 (0.45–0.97)0.013
Hematopoietic cancer (N = 411)
 All, number of cases (%)18 (4.38)97 (23.60)160 (38.93)136 (33.09)
  HR (95% CI)b1.00 (reference)1.33 (0.80–2.20)1.08 (0.66–1.76)1.27 (0.77–2.08)0.894
Digestive cancere (N = 274)
 All, number of cases (%)22 (8.03)63 (22.99)115 (41.97)74 (27.01)
  HR (95% CI)b1.00 (reference)0.72 (0.44–1.16)0.65 (0.41–1.04)0.59 (0.36–0.95)0.036
Endometrial cancer (N = 270)
 All, number of cases (%)26 (9.63)66 (24.44)105 (38.89)73 (27.04)
  HR (95% CI)b1.00 (reference)0.61 (0.39–0.97)0.48 (0.31–0.73)0.45 (0.29–0.71)<0.001
Thyroid cancer (N = 267)
 All, number of cases (%)16 (5.99)65 (24.34)103 (38.58)83 (31.09)
  HR (95% CI)b1.00 (reference)1.08 (0.62–1.87)0.92 (0.54–1.56)1.08 (0.63–1.86)0.573
Ovarian cancer (N = 248)
 All, number of cases (%)15 (6.05)59 (23.79)101 (40.73)73 (29.43)
  HR (95% CI)b1.00 (reference)0.99 (0.56–1.75)0.87 (0.51–1.51)0.89 (0.51–1.55)0.297
Lung cancer (N = 213)
 All, number of cases (%)32 (15.02)61 (28.64)85 (39.91)35 (16.44)
  HR (95% CI)b1.00 (reference)0.47 (0.31–0.72)0.33 (0.22–0.49)0.19 (0.11–0.30)<0.001

NOTE: Bold values signify P-values < 0.05.

  • aThe health index ranged from 0 (the less healthy) to 5 (the healthiest), with an interval of 0.5 and was calculated by summing the five individual scores (0, 0.5, and 1) based on recommendations on smoking, BMI, alcohol consumption, fruit and vegetable consumption, and physical activity.

  • bAdjusted for level of education, residence, first-degree family history of any cancer, professional activity, use of oral contraceptives, age at menarche and number of children, age at first full-term pregnancy, menopausal status, and use of menopausal hormone therapy.

  • cAdjusted for level of education, residence, first-degree family history of any cancer, professional activity, use of oral contraceptives, age at menarche and number of children, and age at first full-term pregnancy.

  • dAdjusted for level of education, residence, first-degree family history of any cancer, professional activity, use of oral contraceptives, age at menarche and number of children, age at first full-term pregnancy, and use of menopausal hormone.

  • eNoncolorectal digestive cancers included cancers of the pancreas, stomach, liver, biliary tract, esophagus, and small bowel.