Favorable changes in lifestyle reduce risk of colorectal cancer


Dr Veena Aggarwal, Consultant Womens’ Health, CMD and Editor-in-Chief, IJCP Group & Medtalks Trustee, Dr KK’s Heart Care Foundation of India    09 January 2023

Favorable changes in lifestyle are associated with lower risk of colorectal cancer, suggests a study published in the American Journal of Gastroenterology.1,2


In this study, a team of European researchers set out to examine if alterations in lifestyle had any impact on the risk of colorectal cancer. A total of 295,865 participants from across Europe were included in the study. Data was sourced from the European Prospective Investigation into Cancer cohort. A Healthy Lifestyle Index (HLI) score was calculated based on physical activity, body mass index, smoking status and alcohol consumption. Information was obtained via two questionnaires (baseline and at follow-up) answered at a gap of 5.7 years. The scores ranged from 0 to 16 with higher scores indicative of a healthy lifestyle.


Over a median follow up period of 7.8 years, 2799 participants developed colorectal cancer. For every one unit increase in the healthy lifestyle index (HLI) score, the risk of CRC decreased by 3%. Among the subjects who had an HLI score greater than 11 at baseline, those with a score of ≤9 “unfavorable lifestyle” at follow-up had higher probability of CRC with hazard ratio (HR) 1.34 vs those whose scores remained in the >11 upper tertile “favorable lifestyle”. Among those who scored ≤9 on the HLI Index at study entry, participants with an HLI score of >11 at follow-up lowered their risk of developing CRC with HR 0.77 vs those whose scores remained ≤9 bottom tertile.


Decrease in alcohol intake and body weight and increase in physical activity were associated with reduced risk of colorectal cancer.


This study demonstrates an inverse association between a healthy lifestyle and risk of colorectal cancer. Favorable changes in lifestyle and greater adherence to a healthy lifestyle reduced the risk, while failure to adopt and follow a healthy lifestyle increased the risk of colorectal cancer. These findings, state the researchers, add to the evidence supporting “recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention”.




  1. Edoardo Botteri, et al. Changes in lifestyle and risk of colorectal cancer in the European Prospective Investigation into cancer and nutrition. Am J Gastroenterol. 2022 Dec 2. doi: 10.14309/ajg.0000000000002065.
  2. Lifestyle changes may reduce colorectal cancer risk - Medscape - Dec 30, 2022.

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