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@ARTICLE{Naudin:154108,
      author       = {S. Naudin and M. Solans Margalef and F. Saberi Hosnijeh and
                      A. Nieters and C. Kyrø and A. Tjønneland and C. C. Dahm
                      and K. Overvad and Y. Mahamat-Saleh and C. Besson and M.-C.
                      Boutron-Ruault and T. Kühn$^*$ and F. Canzian$^*$ and M. B.
                      Schulze and E. Peppa and A. Karakatsani and A. Trichopoulou
                      and S. Sieri and G. Masala and S. Panico and R. Tumino and
                      F. Ricceri and S. L. F. Chen and L. L. Barroso and J. M.
                      Huerta and M.-J. Sánchez and E. Ardanaz and V. Menéndez
                      and P. Amiano Exezarreta and F. Spaeth and M. Jerkeman and
                      K. Jirstom and J. A. Schmidt and D. Aune and E. Weiderpass
                      and E. Riboli and R. Vermeulen and D. Casabonne and M.
                      Gunter and P. Brennan and P. Ferrari},
      title        = {{H}ealthy lifestyle and the risk of lymphoma in the {EPIC}
                      study.},
      journal      = {International journal of cancer},
      volume       = {147},
      number       = {6},
      issn         = {1097-0215},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2020-00569},
      pages        = {1649-1656},
      year         = {2020},
      note         = {2020 Sep 15;147(6):1649-1656},
      abstract     = {Limited evidence exists on the role of modifiable lifestyle
                      factors on the risk of lymphoma. In this work, the
                      associations between adherence to healthy lifestyles and
                      risks of Hodgkin lymphoma (HL) and non-Hodgkin lymphoma
                      (NHL) were evaluated in a large-scale European prospective
                      cohort. Within the European Prospective Investigation into
                      Cancer and Nutrition (EPIC), 2,999 incident lymphoma cases
                      (132 HL and 2,746 NHL) were diagnosed among 453,808
                      participants after 15 years (median) of follow-up. The
                      healthy lifestyle index (HLI) score combined information on
                      smoking, alcohol intake, diet, physical activity and BMI,
                      with large values of HLI expressing adherence to healthy
                      behavior. Cox proportional hazards models were used to
                      estimate lymphoma hazard ratios (HR) and $95\%$ confidence
                      interval (CI). Sensitivity analyses were conducted by
                      excluding, in turn, each lifestyle factor from the HLI
                      score. The HLI was inversely associated with HL, with HR for
                      a 1-standard deviation (SD) increment in the score equal to
                      0.78 $(95\%CI:$ 0.66, 0.94). Sensitivity analyses showed
                      that the association was mainly driven by smoking and
                      marginally by diet. NHL risk was not associated with the
                      HLI, with HRs for a 1-SD increment equal to 0.99 (0.95,
                      1.03), with no evidence for heterogeneity in the association
                      across NHL subtypes. In the EPIC study, adherence to healthy
                      lifestyles was not associated with overall lymphoma or NHL
                      risk, while an inverse association was observed for HL,
                      although this was largely attributable to smoking. These
                      findings suggest a limited role of lifestyle factors in the
                      etiology of lymphoma subtypes. This article is protected by
                      copyright. All rights reserved.},
      cin          = {C020 / C055},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331 / I:(DE-He78)C055-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32176325},
      doi          = {10.1002/ijc.32977},
      url          = {https://inrepo02.dkfz.de/record/154108},
}