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.

中文翻译：

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欧洲癌症和营养前瞻性调查研究中的健康生活方式和淋巴瘤风险。


关于可改变的生活方式因素对淋巴瘤风险的影响的证据有限。在这项工作中，在大规模欧洲前瞻性队列中评估了坚持健康生活方式与霍奇金淋巴瘤（HL）和非霍奇金淋巴瘤（NHL）风险之间的关联。在欧洲癌症与营养前瞻性调查 (EPIC) 中，经过 15 年（中位数）随访，453,808 名参与者中诊断出 2,999 例淋巴瘤病例（132 例 HL 和 2,746 例 NHL）。健康生活方式指数（HLI）得分综合了吸烟、饮酒、饮食、体力活动和体重指数等信息，HLI 值较大表示对健康行为的坚持。 Cox 比例风险模型用于估计淋巴瘤风险比 (HR) 和 95% 置信区间 (CI)。通过依次从 HLI 评分中排除每个生活方式因素来进行敏感性分析。 HLI 与 HL 呈负相关，分数中 1 标准差 (SD) 增量的 HR 等于 0.78（95% CI：0.66，0.94）。敏感性分析表明，这种关联主要是由吸烟驱动的，饮食也有少量驱动。 NHL 风险与 HLI 无关，1-SD 增量的 HR 等于 0.99（0.95，1.03），没有证据表明 NHL 亚型之间的关联存在异质性。在 EPIC 研究中，坚持健康的生活方式与总体淋巴瘤或 NHL 风险无关，而与 HL 呈负相关，尽管这主要归因于吸烟。这些发现表明生活方式因素在淋巴瘤亚型的病因学中的作用有限。