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@ARTICLE{Erben:143173,
      author       = {V. Erben$^*$ and P. Carr$^*$ and B. Holleczek and C.
                      Stegmaier and M. Hoffmeister$^*$ and H. Brenner$^*$},
      title        = {{S}trong associations of a healthy lifestyle with all
                      stages of colorectal carcinogenesis: {R}esults from a large
                      cohort of participants of screening colonoscopy.110},
      journal      = {International journal of cancer},
      volume       = {144},
      number       = {9},
      issn         = {1097-0215},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2019-00772},
      pages        = {2135-2143},
      year         = {2019},
      abstract     = {The risk of developing colorectal cancer (CRC) is
                      associated with a wide range of dietary and lifestyle
                      factors. The individual contribution of single modifiable
                      factors, such as alcohol consumption, physical activity,
                      smoking, body mass index (BMI) or dietary components, to the
                      development of CRC has been investigated extensively, but
                      evidence on their combined effect at various stages of
                      colorectal carcinogenesis is sparse. The aim of our study
                      was to analyze the association of a healthy lifestyle
                      pattern with prevalence of early and advanced colorectal
                      neoplasms. A total of 13,600 participants of screening
                      colonoscopy in Saarland/Germany (mean age 62.9 years) who
                      were enrolled in the KolosSal study (Effektivität der
                      Früherkennungs-Koloskopie: eine Saarland-weite Studie) from
                      2005 until 2013 were included in this cross-sectional
                      analysis. Dietary and lifestyle data were collected and
                      colonoscopy results were extracted from physicians' reports.
                      The association of an a priori defined healthy lifestyle
                      score-including dietary intake, alcohol consumption,
                      physical activity, smoking and BMI-with early and advanced
                      colorectal neoplasms was assessed by multiple logistic
                      regression analyses with comprehensive adjustment for
                      potential confounders. Strong inverse dose-response
                      relationships were observed between an overall healthier
                      lifestyle pattern and presence of advanced colorectal
                      neoplasms, nonadvanced adenomas and hyperplastic polyps (p
                      value <0.0001 in all cases), with adjusted odds ratios
                      $(95\%$ CI) for the highest compared to the lowest category
                      of the healthy lifestyle score of 0.41 (0.30-0.56), 0.42
                      (0.33-0.54) and 0.39 (0.29-0.54) respectively. A healthy
                      lifestyle is strongly associated with lower risk of all
                      stages of colorectal neoplasms.},
      cin          = {C120 / C070 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)C120-20160331 / I:(DE-He78)C070-20160331 /
                      I:(DE-He78)L101-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30468245},
      doi          = {10.1002/ijc.32011},
      url          = {https://inrepo02.dkfz.de/record/143173},
}