Life's Essential 8 and the Risk of Overall and Specific-Site Cancer Types: A Large-Scale Prospective Cohort Study.

BACKGROUND: The Life's Essential 8 (LE8) framework, designed to prevent cardiovascular disease, is also linked to cancer risk, but the direct association between LE8 adherence and cancer incidence remains underexplored. Each LE8 component may affect cancer risk differently across organ systems, warranting further investigation into these relationships. METHODS: This prospective cohort study utilized data from the Kailuan Study, comprising 94,239 participants from Tangshan, China. LE8 scores were calculated based on lifestyle and physiological measures, including diet, physical activity, and biomarkers such as blood glucose and cholesterol levels. Incident cancer cases were monitored through biennial health assessments and verified through multiple data sources until December 31, 2022. Cox proportional hazards models and competing risk models adjusted for confounders like age, sex, and lifestyle factors were used to analyze the impact of LE8 as well as each LE8 component on various cancer types. RESULTS: During a median follow-up of 14.99 years, 5124 incident cancer cases were identified. Compared to poor LE8 adherence, intermediate and ideal adherence groups showed a 13% (HR = 0.87; 95% CI: 0.80-0.96) and 26% (HR = 0.74; 95% CI: 0.65-0.85) decrease in overall cancer incidence, respectively. Improvements in LE8 scores were linked to reduced risks of specific cancers: lung (9%), breast (12%), kidney (18%), colorectal (7%), and endometrial (31%), with hazard ratios of 0.91, 0.88, 0.82, 0.93, and 0.69, respectively. Ideal blood pressure and non-smoking were protective against cancer, while ideal body weight increased the risk. Non-smoking reduced lung and kidney cancer risk, while ideal BMI had mixed effects. CONCLUSIONS: Our findings support the LE8 framework as an effective tool for cancer prevention, with higher adherence linked to lower cancer incidence across various types. The results advocate for the integration of LE8 into broader public health and clinical strategies. TRIAL REGISTRATION: Kailuan study, ChiCTR-TNRC-11001489. Registered August 24, 2011-Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=8050.