Adherence to a healthy lifestyle in relation to colorectal cancer incidence and all‐cause mortality after endoscopic polypectomy: A prospective study in three U.S. cohorts.

It remains unknown whether maintenance of a healthy lifestyle after endoscopic polypectomy could still confer benefit for colorectal cancer (CRC) incidence and mortality. In this study, we defined a healthy lifestyle score based on body mass index, smoking, physical activity, alcohol consumption and diet (range, 0‐5). We used Cox proportional hazards regression to estimate the hazard ratios (HRs) for the associations of healthy lifestyle score and individual lifestyle factors with CRC incidence and all‐cause mortality. During a median of 10 years of follow‐up of 24 668 participants who underwent endoscopic polypectomy, we documented 161 CRC cases and 4857 all‐cause deaths. A higher healthy lifestyle score after endoscopic polypectomy was associated with lower risk of CRC and all‐cause mortality. Compared with individuals with 0 to 1 healthy lifestyle factors, those with 2, 3 and 4 to 5 healthy lifestyle factors had a HR for CRC risk of 0.86 (95% confidence interval [CI], 0.60‐1.24), 0.73 (95% CI, 0.47‐1.14) and 0.52 (95% CI, 0.27‐1.01), respectively (Ptrend =.03). The corresponding HR (95% CI) for all‐cause mortality was 0.83 (95% CI, 0.76‐0.90), 0.63 (95% CI, 0.56‐0.70) and 0.56 (95% CI, 0.48‐0.65), respectively (Ptrend <.0001). In the joint analysis of pre‐ and postpolypectomy periods, patients with a healthy postpolypectomy lifestyle had a lower incidence of CRC regardless of their prepolypectomy exposure, whereas those with a healthy lifestyle in both periods had a lower mortality than those with an unhealthy lifestyle in either period. In conclusion, adherence to a healthy lifestyle after polypectomy may confer significant benefit for CRC prevention and reduction in all‐cause mortality. [ABSTRACT FROM AUTHOR]