Combined prediagnostic lifestyle factors and survival of breast, colorectal and lung cancer in the Norwegian Women and Cancer (NOWAC) study: a prospective cohort study
Bibliographic record
Abstract
BACKGROUND: With improvements in cancer treatment and early detection, the number of people living with cancer is increasing. OBJECTIVE: This study aimed to investigate the association between combined prediagnostic lifestyle factors, assessed by a Healthy Lifestyle Index (HLI) score, and mortality among women diagnosed with breast cancer (BC), colorectal cancer (CRC) and lung cancer (LC). DESIGN: Prospective cohort. SETTING: Women residing in Norway, general population. PARTICIPANTS: Our analysis included 5032, 2468 and 1594 women from the Norwegian Women and Cancer study diagnosed with BC, CRC and LC, respectively, who responded to a questionnaire between 1996 and 2014. EXPOSURE MEASURES: HLI score measured prior to cancer diagnosis. The HLI combines physical activity level, body mass index, smoking behaviour, alcohol consumption and dietary habits. OUTCOME MEASURES: We estimated HRs and 95% CIs using Cox proportional hazard models for all-cause and site-specific cancer mortality. RESULTS: After median follow-up times of 9.8, 7.1 and 5.9 years for BC, CRC and LC cases, respectively, there were 912, 902 and 1094 all-cause deaths; and 509 BC deaths, 679 CRC deaths and 961 LC deaths. For women diagnosed with BC, a 1-point HLI score increment was associated with a 6% lower all-cause mortality rate (HR: 0.94, 95% CI: 0.92 to 0.97). The data were compatible with no association for the estimated 3% lower BC mortality rate (HR: 0.97, 95% CI: 0.94 to 1.00) among women diagnosed with BC, and for the estimated 3% lower all-cause (HR: 0.97, 95% CI: 0.95 to 1.00) and 2% lower CRC mortality rates (HR: 0.98, 95% CI: 0.95 to 1.01) among women diagnosed with CRC. For women diagnosed with LC, prediagnostic HLI score was not associated with all-cause (HR: 1.00, 95% CI: 0.98 to 1.02) or LC mortality rates (HR: 1.00, 95% CI: 0.98 to 1.03). CONCLUSIONS: We observed that a higher HLI score measured before cancer diagnosis was associated with lower all-cause and, possibly, lower BC mortality among Norwegian women diagnosed with BC; and a possible lower all-cause and CRC mortality among those diagnosed with CRC. Smoking was likely responsible for the observed associations.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".