Table 3.

Associations (HRs, 95% CIs) between WCRF/AICR lifestyle scores (in quintiles and continuously) and risk of colorectal cancer outcomes among men in the HPFS and women in the NHS

Q1Q2Q3Q4Q5ContinuousaPtrendbPheterogeneityc
Mean (SD) score
 Men1.10 (0.27)1.61 (0.11)1.92 (0.07)2.18 (0.10)2.51 (0.14)
 Women0.90 (0.22)1.37 (0.11)1.70 (0.09)2.01 (0.11)2.36 (0.16)
Total colorectal cancer
 Men
  No. of cases277256240195183
  Age-adjusted1.00 (ref)0.87 (0.73–1.03)0.78 (0.66–0.93)0.65 (0.54–0.78)0.59 (0.49–0.71)0.75 (0.69–0.81)<0.0001
  MV-adjustedd1.00 (ref)0.90 (0.76–1.07)0.83 (0.69–0.99)0.70 (0.58–0.85)0.64 (0.52–0.77)0.78 (0.72–0.85)<0.0001
 Women0.006
  No. of cases269268260248253
  Age-adjusted1.00 (ref)0.89 (0.75–1.06)0.83 (0.70–0.98)0.77 (0.64–0.91)0.75 (0.63–0.89)0.86 (0.79–0.93)0.0002
  MV-adjustede1.00 (ref)0.94 (0.79–1.12)0.90 (0.76–1.07)0.86 (0.72–1.02)0.86 (0.72–1.02)0.92 (0.85–1.00)0.06
Total colon cancer
 Men
  No. of cases230196193146142
  Age-adjusted1.00 (ref)0.80 (0.66–0.97)0.76 (0.63–0.92)0.58 (0.47–0.72)0.55 (0.44–0.67)0.72 (0.66–0.79)<0.0001
  MV-adjustedd1.00 (ref)0.83 (0.68–1.00)0.80 (0.65–0.97)0.62 (0.50–0.77)0.58 (0.47–0.73)0.75 (0.68–0.82)<0.0001
 Women0.002
  No. of cases215213195193207
  Age-adjusted1.00 (ref)0.88 (0.73–1.07)0.77 (0.63–0.94)0.74 (0.61–0.90)0.76 (0.62–0.92)0.87 (0.79–0.95)0.003
  MV-adjustede1.00 (ref)0.92 (0.76–1.11)0.83 (0.68–1.00)0.81 (0.67–0.99)0.84 (0.69–1.03)0.92 (0.84–1.02)0.10
Proximal colon cancer
 Men
  No. of cases7994916368
  Age-adjusted1.00 (ref)1.10 (0.81–1.48)1.03 (0.76–1.40)0.72 (0.52–1.01)0.76 (0.55–1.06)0.83 (0.72–0.95)0.009
  MV-adjustedd1.00 (ref)1.12 (0.83–1.52)1.06 (0.78–1.45)0.77 (0.55–1.09)0.82 (0.58–1.15)0.86 (0.74–1.00)0.05
 Women0.41
  No. of cases139124114134135
  Age-adjusted1.00 (ref)0.78 (0.61–0.99)0.68 (0.53–0.87)0.78 (0.62–0.99)0.75 (0.59–0.95)0.88 (0.78–1.00)0.04
  MV-adjustede1.00 (ref)0.81 (0.63–1.03)0.73 (0.56–0.93)0.85 (0.67–1.09)0.83 (0.64–1.06)0.94 (0.83–1.06)0.30
Distal colon cancer
 Men
  No. of cases9771645247
  Age-adjusted1.00 (ref)0.70 (0.51–0.95)0.62 (0.45–0.85)0.51 (0.36–0.71)0.43 (0.30–0.61)0.66 (0.57–0.76)<0.0001
  MV-adjustedd1.00 (ref)0.72 (0.53–0.99)0.66 (0.47–0.91)0.55 (0.38–0.77)0.47 (0.33–0.68)0.69 (0.59–0.80)<0.0001
 Women0.04
  No. of cases6985775265
  Age-adjusted1.00 (ref)1.14 (0.83–1.56)0.99 (0.72–1.38)0.65 (0.45–0.93)0.77 (0.55–1.08)0.84 (0.71–0.98)0.02
  MV-adjustede1.00 (ref)1.20 (0.87–1.65)1.05 (0.75–1.46)0.70 (0.48–1.01)0.83 (0.59–1.19)0.87 (0.74–1.03)0.10
Rectal cancer
 Men
  No. of cases4760474941
  Age-adjusted1.00 (ref)1.20 (0.82–1.77)0.90 (0.60–1.35)0.97 (0.65–1.46)0.79 (0.52–1.20)0.86 (0.72–1.03)0.09
  MV-adjustedd1.00 (ref)1.27 (0.86–1.88)0.98 (0.65–1.48)1.07 (0.71–1.62)0.89 (0.58–1.39)0.91 (0.76–1.10)0.33
 Women0.95
  No. of cases5455655546
  Age-adjusted1.00 (ref)0.93 (0.64–1.36)1.06 (0.74–1.52)0.85 (0.59–1.24)0.71 (0.48–1.06)0.81 (0.68–0.97)0.02
  MV-adjustede1.00 (ref)1.03 (0.70–1.50)1.23 (0.85–1.78)1.03 (0.70–1.51)0.90 (0.60–1.36)0.92 (0.76–1.10)0.37
  • aPer one interquartile range increase in the WCRF/AICR lifestyle score.

  • bP value for the continuous WCRF/AICR lifestyle score.

  • cPheterogeneity between NHS and HPFS for the continuous WCRF/AICR lifestyle score.

  • dAdjusted for total energy intake (kcal/day, quintiles), NSAID/aspirin use [≥2 pills/week vs. <2 pills/week (ref)], family history of colorectal cancer [yes vs. no (ref)], previous colorectal cancer screening via colonoscopy or sigmoidoscopy [yes vs. no (ref)], history of polyps [yes vs. no (ref)], smoking [never smoker (ref), >0–<10, ≥10-<20, ≥20–<30, ≥30–<40, ≥40–<50, ≥50 pack-years), multivitamin use [regular use vs. nonuse (ref)], supplemental calcium intake [none (ref), >0–<200, ≥200–<400, ≥400–<600, ≥600 mg/day], and young adult body mass index [<25 (ref), ≥25–<27.5, ≥27.5–<30, ≥30 kg/m2].

  • eAdjusted for same as multivariable models in men + menopausal status [postmenopausal vs. not (ref)], and postmenopausal hormone use [never use (ref), past use, current use].