LIFESTYLE & BOWEL CANCER
Published May 2015, in BioMed Central (BMC) Medicine
Authors: Dora Romaguera and Others
Bowel cancer, also called colorectal cancer, is the second most common cancer in men and the third most common cancer in women worldwide, with 55 per cent cases occurring in developed regions such as North America and Western Europe. Survival rates of bowel cancer have wide variations even in people with similar tumours and receiving the same treatment.
Following lifestyle guidelines about diet, physical activity and maintaining a healthy weight both before and after diagnosis of bowel cancer is associated with an improved likelihood of survival, show the findings of a large study of 520,000 individuals from 10 countries. The study is part of the European Prospective Investigation into Cancer and Nutrition (EPIC), one of the largest cohort studies in the world.
Lead researcher Dora Romaguera from Imperial College, London, and CIBER-OBN, says: “Current advice given to cancer survivors about lifestyle is to follow the same lifestyle recommendations for cancer prevention… We wanted to see if following these recommendations were associated with the survivability of bowel cancer.”
During the study period of an average of 6.4 years, 3,292 participants were diagnosed with bowel cancer. Researchers developed a scoring system based on guidelines from the World Cancer Research Fund, who funded the study, and American Institute of Cancer Research with recommendations on cancer prevention. These guidelines have also been recommended to cancer survivors due to the lack of specific guidelines for survivors.
A six-point score was constructed for men based on recommendations in the guidelines about body weight, physical activity, food and drinks that promote weight gain, plant foods, meat-based food, and alcoholic drinks. Women had a seven-point score based on the previous six recommendations and whether or not they had breastfed. Points were allocated based on meeting these recommendations.
It was found that men who had a lifestyle score of 3 or more were more likely to survive bowel cancer. For women, a score of 4 or above was associated with increased survival. In both cases, the higher the score, the lower the risk of mortality after bowel cancer.
When the individual recommendations were studied, it was found that having a healthy weight and high plant foods consumption had the strongest associations with survival. There was also an association seen with women who breastfed and survival of bowel cancer. This has been seen for breast cancer before but is the first time it has been seen in bowel cancer.
“The results demonstrate that a healthy lifestyle in your adult life, in line with recommendations on diet, physical activity and body weight for cancer prevention, do not only prevent developing bowel cancer but, in those who eventually developed it, it improves survival,” says Romaguera.