Adherence to Healthy Lifestyle and Liver cancer in Chinese: a prospective cohort study of 0.5 million people

• Published in: British journal of cancer Vol. 126; no. 5; pp. 815 - 821
• Main Authors: Song, Ci, Lv, Jun, Yu, Chengxiao, Zhu, Meng, Yu, Canqing, Guo, Yu, Yang, Ling, Chen, Yiping, Chen, Zhengming, Jiang, Tao, Ma, Hongxia, Jin, Guangfu, Shen, Hongbing, Hu, Zhibin, Li, Liming
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 23-03-2022; Nature Publishing Group
• Subjects: 692/4028/67/2324; 692/499; Adult; Aged; Biomedical and Life Sciences; Biomedicine; Cancer Research; China - epidemiology; Cohort analysis; Drug Resistance; Epidemiology; Female; Health behavior; Healthy Lifestyle; Hepatitis B - epidemiology; Hepatitis B - immunology; Hepatitis B surface antigen; Hepatitis B Surface Antigens - metabolism; Hepatitis B virus - immunology; Humans; Life Style; Lifestyles; Liver cancer; Liver Neoplasms - epidemiology; Liver Neoplasms - virology; Male; Middle Aged; Molecular Medicine; Oncology; Physical activity; Prospective Studies; Waist-Hip Ratio; China
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/s41416-021-01645-x

Background
Little prospective evidence exists about whether a combination of healthy lifestyle factors is related to a considerable reduction of liver cancer risk.
Methods
Based on the prospective China Kadoorie Biobank (CKB) cohort with a total of 492,640 Chinese adults, we examined the associations of five lifestyle factors with risk of liver cancer. Low-risk lifestyle factors were defined as non-smoking, non-drinking, median or higher level of physical activity, a healthy diet, and waist-to-hip ratio (WHR) < 0.90 for men and <0.85 for women.
Results
During a median of 10.12 years of follow-up, 2529 liver cancer events were observed. There was a significant decrease in liver cancer risk with the increasing of the healthy lifestyle index scores (
P
 < 0.001). Participants with a favourable lifestyle (4 or 5 healthy lifestyle factors) had a 43% reduced liver cancer risk compared with those with an unfavourable lifestyle (0 or 1 healthy lifestyle factor) (HR, 0.57 [95% CI, 0.47–0.68]). The cumulative protective effect of a healthy lifestyle on liver cancer appeared to be more dramatic for patients with hepatitis B surface antigen (HBsAg) positive, the individuals at high risk of liver cancer.
Conclusions
Individuals adhering to a favourable lifestyle was associated with a considerable absolute risk reduction of liver cancer.