Abstract

Introduction Some modifiable lifestyle factors have been associated with decreased breast cancer risk. This study aimed to assess the association of a combined healthy lifestyle index with the risk of breast cancer in Moroccan women. Methods A case-control study was conducted in Fez region - Morocco, from February 2016 to August 2017. A total of 300 incident breast cancer cases and 300 controls, matched to cases by age (± 5 years) and area of residence, were recruited in the study. Cases were women newly diagnosed with histologically confirmed breast cancer at the University Hospital of Fez, and controls were healthy women recruited at one of six outpatient primary health centers randomly selected from the Fez region. For each participant we calculated a healthy lifestyle index based on five lifestyle factors (body mass index, smoking, fruits and vegetables consumption, physical activity, and alcohol consumption), by assigning scores of 0 to 1 to categories of each factors. Women with healthiest behavior were never smokers, had a BMI within 18.5 to 25 kg/m2, consumed at least 5 servings of fruits and vegetables per day, drank less than one alcoholic drink per day, and had a recreational physical activity of at least 20 MET-hours per week. The health index ranged from 0 (least healthy) to 5 (most healthy). Conditional logistic regression was used to assess the association between the healthy lifestyle score and breast cancer risk adjusting for confounding factors. Results The mean of combined score in cases and controls were 3.22 (± 0.75) and 3.65 (± 0.60), for the two groups respectively (P-value difference Conclusions Healthy lifestyle was associated with a decreased risk of breast cancer. These findings suggest that breast cancer prevention policies should include strategies to engage Moroccan women in healthy lifestyles.

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