Healthy lifestyle and breast cancer risk: A case-control study in Morocco. (February 2019)

• Record Type: Journal Article
• Authors: Khalis, Mohamed; Chajès, Véronique; Moskal, Aurelie; Biessy, Carine; Huybrechts, Inge; Rinaldi, Sabina; Dossus, Laure; Charaka, Hafida; Mellas, Nawfel; Nejjari, Chakib; Dorn, Joan; Soliman, Amr S.; Romieu, Isabelle; El Rhazi, Karima; Charbotel, Barbara
• Is Part Of: Cancer epidemiology. Volume 58(2019:Feb.)
• Page Start: 160
• Page End: 166
• Publication Date: 2019-02
• Subjects: BC breast cancer -- LMIC low-income and middle-income countries -- HLI healthy lifestyle index -- BMI body mass index -- METs metabolic equivalents -- OR odds ratio -- CI confidence intervals -- SD standard deviation; Breast cancer -- Health index -- Lifestyle -- Case–control -- Morocco -- Developing countries; Cancer -- Epidemiology -- Periodicals; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Carcinogenesis -- Periodicals; 616.994005
• DOI: 10.1016/j.canep.2018.12.012
• Languages: English
• ISSNs: 1877-7821

Abstract

Highlights: This study is the first to evaluate the association between healthy lifestyle scores and the risk of breast cancer in Morocco. High healthy lifestyle index scores were associated with decreased risk of breast cancer. Lifestyle factors should be considered in breast cancer prevention policies and interventions in Morocco and similar developing countries. Abstract: Background: Some modifiable risk factors have been independently associated with breast cancer (BC) risk in Moroccan women, but no studies have investigated their joint association. This study aimed to investigate the association between a Healthy Lifestyle Index (HLI) score and BC risk among Moroccan women. Methods: In this case–control study, 300 incident BC cases and 300 controls, matched by age and area of residence were recruited. Cases were women newly-diagnosed with histopathologically–confirmed BC at the University Hospital in Fez, Morocco. Controls were randomly selected healthy women recruited from 6 primary health centers in Fez. HLI scores developed within this study were assigned to participants based on 11 factors (red and processed meat, white meat, cream, cheese, fish, fruit and vegetables, physical activity, BMI, smoking, alcohol consumption, and breastfeeding), where 0 was given to unhealthy and 0.5 or 1 to healthy levels of each factor. Conditional and unconditional logistic regression models were used to assess the association between HLI scores and BC risk. Results: Mean of HLI scores were 8.1 (±1.1) and 9.0 (±0.9) in cases and controls, respectively, p < 0.01. After adjusting for potential confounders, one-point increment in the HLI score was associated with 56% (95% CI, CI: 39–68%), 49% (95% CI: 30–63%), and 59% (95% CI: 40–72%) lower risks of BC in all, premenopausal, and postmenopausal women, respectively. Conclusion: High HLI scores were associated with decreased risk of BC in Moroccan women. These findings suggest that BC prevention policies should include strategies for engaging Moroccan women in healthy lifestyles.