Table 2.
Hazard ratios and 95% CIs for associations between post-diagnostic WCRF/AICR lifestyle scores and mortality among colorectal cancer patients.
| Quartile of post-diagnostic WCRF/AICR lifestyle scores | P- continuous |
per IQR increasea |
||||
|---|---|---|---|---|---|---|
| Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | |||
| Post-diagnostic WCRF/AICR lifestyle score with BMI | ||||||
| Median score (NHS) | 0.93 | 1.50 | 1.89 | 2.36 | ||
| Median score (HPFS) | 1.29 | 1.71 | 2.04 | 2.39 | ||
| Colorectal cancer specific mortality | ||||||
| No. of events | 48 | 46 | 47 | 38 | 179 | |
| Model 1 HR (95% CI)b | Referent | 0.97 (0.64-1.46) | 0.96 (0.64-1.43) | 0.78 (0.51-1.20) | 0.16 | 0.88 (0.73-1.05) |
| Model 2 HR (95% CI)c | Referent | 0.99 (0.66-1.49) | 0.98 (0.65-1.47) | 0.80 (0.52-1.23) | 0.29 | 0.91 (0.75-1.09) |
| Model 3 HR (95% CI)d | Referent | 0.97 (0.65-1.46) | 0.94 (0.63-1.42) | 0.76 (0.49-1.18) | 0.18 | 0.86 (0.70-1.07) |
| Model 4 HR (95% CI)e | Referent | 1.02 (0.67-1.56) | 1.03 (0.65-1.62) | 0.86 (0.51-1.46) | 0.53 | 0.91 (0.69-1.21) |
| Overall mortality | ||||||
| No. of events | 179 | 155 | 167 | 140 | 641 | |
| Model 1 HR (95% CI)b | Referent | 0.75 (0.60-0.93) | 0.79 (0.63-0.97) | 0.61 (0.49-0.76) | 0.05 | 0.91 (0.83-1.00) |
| Model 2 HR (95% CI)c | Referent | 0.75 (0.61-0.94) | 0.79 (0.64-0.98) | 0.62 (0.49-0.77) | 0.01 | 0.88 (0.80-0.97) |
| Model 3 HR (95% CI)d | Referent | 0.77 (0.62-0.95) | 0.78 (0.63-0.97) | 0.63 (0.50-0.78) | <0.001 | 0.80 (0.72-0.90) |
| Model 4 HR (95% CI)e | Referent | 0.82 (0.65-1.03) | 0.87 (0.68-1.11) | 0.74 (0.56-0.98) | 0.08 | 0.88 (0.76-1.02) |
| Post-diagnostic WCRF/AICR lifestyle score without BMI | ||||||
| Median score (NHS) | 0.59 | 0.96 | 1.21 | 1.50 | ||
| Median score (HPFS) | 0.86 | 1.14 | 1.32 | 1.61 | ||
| Colorectal cancer specific mortality | ||||||
| No. of events | 57 | 51 | 40 | 31 | 179 | |
| Model 1 HR (95% CI)b | Referent | 0.92 (0.63-1.34) | 0.69 (0.46-1.04) | 0.51 (0.33-0.78) | 0.002 | 0.73 (0.61-0.89) |
| Model 2 HR (95% CI)c | Referent | 0.98 (0.67-1.44) | 0.75 (0.50-1.13) | 0.54 (0.35-0.84) | 0.01 | 0.77 (0.64-0.94) |
| Model 3 HR (95% CI)d | Referent | 0.97 (0.66-1.43) | 0.72 (0.47-1.09) | 0.50 (0.32-0.79) | 0.003 | 0.72 (0.59-0.89) |
| Model 4 HR (95% CI)e | Referent | 1.01 (0.68-1.50) | 0.76 (0.49-1.18) | 0.54 (0.33-0.88) | 0.02 | 0.76 (0.60-0.96) |
| Overall mortality | ||||||
| No. of events | 194 | 162 | 144 | 141 | 641 | |
| Model 1 HR (95% CI)b | Referent | 0.83 (0.67-1.02) | 0.68 (0.55-0.85) | 0.58 (0.46-0.72) | <0.001 | 0.82 (0.74-0.91) |
| Model 2 HR (95% CI)c | Referent | 0.85 (0.69-1.05) | 0.70 (0.56-0.87) | 0.58 (0.47-0.73) | <0.001 | 0.81 (0.73-0.89) |
| Model 3 HR (95% CI)d | Referent | 0.88 (0.71-1.09) | 0.70 (0.56-0.87) | 0.59 (0.47-0.75) | <0.001 | 0.76 (0.67-0.85) |
| Model 4 HR (95% CI)e | Referent | 0.92 (0.74-1.15) | 0.76 (0.60-0.96) | 0.66 (0.52-0.85) | <0.001 | 0.80 (0.71-0.91) |
IQR (interquartile range) of the post-diagnostic lifestyle score with BMI in NHS=0.89 and in HPFS=0.64. IQR of the post-diagnostic lifestyle score without BMI in NHS=0.54 and in HPFS=0.46.
Model 1: Cox model stratified by age at diagnosis (<65, ≥65 years) and tumor stage (I, II, III, and unspecified), and adjusted for age at diagnosis (continuous).
Model 2: Model 1 + further adjustment for cohort (NHS, HPFS), tumor grade (well differentiated, moderately differentiated, poorly differentiated, and unspecified), tumor subsite (proximal colon, distal colon, rectum, and unspecified), year of diagnosis (continuous), regular sigmoidoscopy/colonoscopy screening (yes, no), and post-diagnostic total energy intake (continuous).
Model 3: Model 2 + further adjustment for post-diagnostic regular use of aspirin (yes, no) and post-diagnostic smoking status (current, non-current) for models of post-diagnostic score with BMI. Post-diagnostic BMI (<23, 23-29.9, ≥30 kg/m2) was additionally adjusted in the models of post-diagnostic lifestyle scores without BMI.
Model 4: Model 3 + further adjustment for pre-diagnostic WCRF/AICR lifestyle score (continuous).
Abbreviations: CRC, colorectal cancer; NHS, Nurses’ Health Study; HPFS: Health Professionals Follow-up Study.