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22 mei 2016: Lees naast de gerelateerde artikelen o.a. ook dit artikel:

https://kanker-actueel.nl/NL/voeding-en-voedingstoffen-en-preventief-effect-bij-kanker-leefstijl-en-voeding-in-eerste-twintig-jaar-van-een-mensenleven-lijkt-bepalend-voor-risico-op-krijgen-van-kanker-toont-grote-zweedse-studie.html

22 mei 2016: Bron: JAMA Oncol. Published online May 19, 2016.

Met een verandering van leefstijl, waarin een hoofdrol voor bewegen, alcohol consumptie, roken en obesitas, zou 20 tot 50 procent van de meeste vormen van kanker te voorkomen zijn. Voor longkanker en darmkanker stijgen die percentages zelfs tot 70 procent. Dit is natuurlijk al veel langer bekend en er wordt ook wel veel aandacht gegeven aan preventie middels leefstijladviezen. Maar is maar weer eens bevestigd nu in een meta analyse van de Nurses’ Health Study en de Health Professionals Follow-up Study,

Een gezonde leefstijl werd gedefinieerd als:

Nooit gerookt hebbende of in ieder geval niet de laatste 5 jaar
Geen of weinig alcohol consumptie (≤1 alcohol bevattend drankje/per dag voor vrouwen, ≤2 alcohol bevattende dankjes/per dag voor mannen),
BMI - Body Mass Index van minstens 18.5 maar in ieder geval lager dan 27.5,
Wekelijks een aerobische of een intensieve fysieke activiteit (echt sporten dus) van tenminste 75 minuten of 150 minuten van bewegen maar mag ook minder intensief en kan dus ook een flinke wandeling zijn.

Deelnemers aan de studie die voldeden aan al die vier criteria vormen de lage risicogroep. Alle andere deelnemers vormen de hoog risciogroep gerelateerd aan hun scores in die vier categorien.

De onderzoekers berekenden het populatie-toerekenbare risico (population-attributable risk - PAR) door de vergelijking te maken van nieuwe diagnoses van kanker en overlijden aan kanker in zijn algemeenheid en per vorm van meest voorkomende vormen van kanker tussen de laag risico en hoog riscio groepen. Verder vergeleken de onderzoekers de resultaten met de gegevens uit de nationale registratie van kanker bij de Amerikaanse bevolking.

Totaal 89 571 vrouwen en 46 339 mannen van de twee studies werden opgenomen in deze studie: 16 531 vrouwen en 11 731 mannen voldeden aan een gezonde leefstijl (laag risico groep), en de overblijvende 73 040 vrouwen en 34 608 mannen bouwden de hoog risico groep op.

Het populatie-toerekenbare risico (PAR) voor de diagnose van nieuwe kanker en overlijden aan kanker in het algemeen zijn de cijfers 25% (nieuwe diagnose) en 48% (overlijden) bij vrouwen en 33% en 44% bij mannen respectievelijk.
Voor individuele vormen van kanker was het populatie-toerekenbare risico (PAR) voor vrouwen en mannen waren respectievelijk 82% en 78% voor longkanker, 29% en 20% voor darmkanker en rectumkanker, 30% en 29% voor alvleesklierkanker en 36% en 44% voor blaaskanker.

Het toerekenbare-risico (PAR) waren 4% (diagnose) en 12% (overlijden) voor borstkanker en 21% voor fatale agressieve prostaatkanker. Substantieel hogere cijfers werden genoteerd wanneer de Par werd vergeleken met de Amerikaanse bevolking. Bv. de PAR lag op 41% bij vrouwen en 63% bij mannen voor kanker in het algemeen en 60% (bij vrouwen) en 59% (bij mannen) voor vormen van darmkanker.

De onderzoekers concluderen dan ook dat preventie van kanker middels lijfstijl veranderingen hoge prioritiet moet krijgen in de voorlichting aan de bevolking. Maar ja hoe lang weten we dat nu al niet?

Het volledige studierapport: Preventable Incidence and Mortality of Carcinoma Associated With Lifestyle Factors Among White Adults in the United States is gratis in te zien of te downloaden. Met duidelijke grafieken en goede beschrijvingen als u goed Engels leest en begrijpt.

Hieronder het abstract van de studie met referentielijst.

A substantial cancer burden may be prevented through lifestyle modification. Primary prevention should remain a priority for cancer control.

Original Investigation | May 19, 2016

Preventable Incidence and Mortality of Carcinoma Associated With Lifestyle Factors Among White Adults in the United States FREE ONLINE FIRST

Mingyang Song, MD, ScD^1,2; Edward Giovannucci, MD, ScD^2,3

[+] Author Affiliations

JAMA Oncol. Published online May 19, 2016. doi:10.1001/jamaoncol.2016.0843

Text Size: A A A

ABSTRACT

Importance Lifestyle factors are important for cancer development. However, a recent study has been interpreted to suggest that random mutations during stem cell divisions are the major contributor to human cancer.

Objective To estimate the proportion of cases and deaths of carcinoma (all cancers except skin, brain, lymphatic, hematologic, and nonfatal prostate malignancies) among whites in the United States that can be potentially prevented by lifestyle modification.

Design, Setting, and Participants This prospective cohort study analyzes cancer and lifestyle data from the Nurses’ Health Study, the Health Professionals Follow-up Study, and US national cancer statistics to evaluate associations between lifestyle and cancer incidence and mortality.

Exposures A healthy lifestyle pattern was defined as never or past smoking (pack-years <5), no or moderate alcohol drinking (≤1 drink/d for women, ≤2 drinks/d for men), BMI of at least 18.5 but lower than 27.5, and weekly aerobic physical activity of at least 75 vigorous-intensity or 150 moderate-intensity minutes. Participants meeting all 4 of these criteria made up the low-risk group; all others, the high-risk group.

Main Outcomes and Measures We calculated the population-attributable risk (PAR) by comparing incidence and mortality of total and major individual carcinomas between the low- and high-risk groups. We further assessed the PAR at the national scale by comparing the low-risk group with the US population.

Results A total of 89 571 women and 46 339 men from 2 cohorts were included in the study: 16 531 women and 11 731 men had a healthy lifestyle pattern (low-risk group), and the remaining 73 040 women and 34 608 men made up the high-risk group. Within the 2 cohorts, the PARs for incidence and mortality of total carcinoma were 25% and 48% in women, and 33% and 44% in men, respectively. For individual cancers, the respective PARs in women and men were 82% and 78% for lung, 29% and 20% for colon and rectum, 30% and 29% for pancreas, and 36% and 44% for bladder. Similar estimates were obtained for mortality. The PARs were 4% and 12% for breast cancer incidence and mortality, and 21% for fatal prostate cancer. Substantially higher PARs were obtained when the low-risk group was compared with the US population. For example, the PARs in women and men were 41% and 63% for incidence of total carcinoma, and 60% and 59% for colorectal cancer, respectively.

Conclusions and Relevance A substantial cancer burden may be prevented through lifestyle modification. Primary prevention should remain a priority for cancer control.

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preventie, lifestyle, leefstijl als preventie van kanker, roken, bewegen, alcohol, obesitas, complementair, literatuurlijst preventie van Engelbert Valstar