Lifestyle changes and postmenopausal breast cancer risk in women from the European Prospective Investigation into Cancer and Nutrition
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The risk of breast cancer has been associated with various lifestyle factors, yet the evidence regarding how lifestyle modifications affect this risk remains limited. This study examines the relationship between changes in the Healthy Lifestyle Index (HLI) and postmenopausal breast cancer risk in women participating in the European Prospective Investigation into Cancer (EPIC). METHODS: HLI scores (ranging from 0 to 16) were computed based on smoking habits, alcohol consumption, body mass index (BMI), and physical activity levels, using data from baseline and follow-up questionnaires, which were separated by a median interval of 10 (IQR: 5.2-12.0) years. Among the 125,746 women included in the analyses, 2,175 developed breast cancer over a median follow-up period of nearly 4 (IQR: 2.9-8.4) years starting from the date of the second lifestyle questionnaire. Cox proportional hazards models were employed to estimate hazard ratios (HRs) and confidence intervals (CIs) for the relationship between changes in HLI and postmenopausal breast cancer risk, analysed both overall and by estrogen receptor (ER) status. Individual components of the HLI were also analysed, with sensitivity analyses addressing potential reverse causation by delaying the start of follow-up by 1 to 3 years. RESULTS: Each unit increase in the HLI-reflecting a healthier lifestyle-was not associated with the overall risk of postmenopausal breast cancer. Among individual components, only a one-unit increase in the BMI score, corresponding to a shift towards a healthier BMI, was inversely associated with overall (HR = 0.936; 95% CI 0.880-0.996) and ER-positive (HR = 0.930; 95% CI 0.865-1.000) postmenopausal breast cancer risks. CONCLUSIONS: Lifestyle changes, as measured by the HLI, during mid-adulthood were not significantly associated with the risk of postmenopausal breast cancer. More specifically, the results of this study suggested that a shift towards a healthier BMI may contribute to breast cancer prevention. Further research involving diverse and larger study populations and lifestyle assessments at earlier life stages could provide deeper insights.
Source: Breast Cancer Research
Authors: Fanélie Vasson, Komodo Matta, Carine Biessy, Christian S. Antoniussen, Agnès Fournier, Chloé Marques, Claire Cadeau, Charlotte Le Cornet, Renée T. Fortner, Matthias B. Schulze, Sabina Sieri, Salvatore Panico, Rosario Tumino, Fulvio Ricceri, Giovanna Masala, Anouk E. Hiensch, Evelyn M. Monninkhof, Antonio Agudo, Marcela Guevara, Sandra M. Colorado-Yohar, Maria-José Sánchez, Adrian Llorente, Sandar Tin Tin, Isobel G. Jackson, Marc J. Gunter, Edoardo Botteri, Pietro Ferrari, Laure Dossus
Institutions: Centre international de recherche sur le cancer, Aarhus University, Inserm, Université de Versailles Saint-Quentin-en-Yvelines, Centre de recherche en Epidémiologie et Santé des Populations, German Cancer Research Center, Norwegian Institute of Public Health, Cancer Registry of Norway, University of Potsdam, German Center for Diabetes Research, German Institute of Human Nutrition, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Naples Federico II, Associazione Iblea per la Ricerca Epidemiologica E.T.S., University of Turin, Utrecht University, University Medical Center Utrecht, Institut d'Investigació Biomédica de Bellvitge, Institut Català d'Oncologia, Instituto de Salud Pública de Navarra, Navarre Institute of Health Research, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Universidad de Antioquia, Instituto Murciano de Investigación Biosanitaria, Instituto de Investigación Biosanitaria de Granada, Andalusian School of Public Health, Basque Government, Biogipuzkoa Health Research Institute, University of Oxford, Imperial College London
Language: English
Topic: Cancer Risks and Factors
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,190
Funders: World Health Organization, Compagnia di San Paolo, Universitetet i Tromsø, Deutsches Krebsforschungszentrum, Cancer Research UK, National Institute for Health and Care Research, Imperial College London, European Commission, Agence Nationale de la Recherche, Institut National de la Santé et de la Recherche Médicale, ZonMw, Bundesministerium für Bildung und Forschung, Cancerfonden, Ministero della Salute, Ligue Contre le Cancer, Vetenskapsrådet, Associazione Italiana per la Ricerca sul Cancro, Deutsche Krebshilfe, Institut National Du Cancer, Institut Gustave-Roussy, Mutuelle Générale de l'Education Nationale, Medical Research Council, World Cancer Research Fund, Instituto de Salud Carlos III, NIHR Imperial Biomedical Research Centre, School of Public Health, Imperial College London
Awards: Aetiology of type 2 diabetes and related metabolic disorders, G1136667113, G2974529408, G3328679326, G4409035895, G4417655372, G4844208673, G4881195352, The EPIC-Norfolk prospective population study: biological and behavioural determinants of health and disease in an ageing population, G527520901, G5315906942, G5469230434, Etude Epidémiologique des Enfants de femmes de l'Education Nationale, G6274749655, G6848493935, G6852031360, G6896564351, G7240651115, EPIC-Oxford: benefits and risks of plant-based diets, G889170443
OpenAlex ID: W4415658206