Cancer survivors with the healthiest combined lifestyle factors had a 43% lower risk of all-cause mortality compared to those with the least healthy lifestyles (HR 0.57).
Meta-Analysis (n=209,659)
Does adherence to a combined healthy lifestyle reduce mortality and cardiovascular disease incidence in cancer survivors?
Adherence to an overall healthy lifestyle pattern is associated with significantly lower risks of all-cause mortality, cancer-specific mortality, and cardiovascular disease incidence among cancer survivors.
Hazard Ratio: 0.57 (95% CI 0.51–0.65)
PURPOSE: Lifestyle factors in cancer survivors are frequently studied individually even though they are often interconnected. This systematic review and meta-analysis investigated the association of combined lifestyle factors on health outcomes among cancer survivors. METHODS: EMBASE, PubMed and Web of Science were searched up to March 2024. Cohort studies examining the associations of at least three combined lifestyle factors with mortality (all-cause/cancer-specific) and cardiovascular disease (CVD) among cancer survivors, were selected. Pooled hazard ratios (pHRs) and 95% confidence intervals (CIs) were estimated using random effects models. Tests for heterogeneity and publication bias were conducted. RESULTS: Twenty-two studies involving 209,659 survivors with an average follow-up duration ranging from 4.1 to 29.1 years were included. pHRs(95%CI) comparing cancer survivors with the healthiest lifestyles versus those with the least healthy lifestyles were 0.57 (0.51-0.65) for all-cause mortality, 0.70 (0.61-0.80) for cancer-specific mortality, and 0.53 (0.46-0.63) for CVD incidence. These associations were largely consistent across subgroup analyses. Colorectal cancer survivors with the healthiest lifestyle experienced 37% lower all-cause mortality and 25% lower cancer-specific mortality, while breast cancer survivors had a 45% reduction in all-cause mortality. Although studies were limited, significant associations for all-cause mortality were observed among lung, liver, nasopharyngeal, gastric, kidney, gynecologic cancer survivors. However, no significant relationship between healthy lifestyles and CVD-specific mortality was detected. CONCLUSIONS: Having an overall healthy lifestyle is associated with lower CVD incidence and better survival among cancer survivors. The long-term management of cancer survivors should consider encouragement for a modification of multiple lifestyles.
Zhu et al. (2024) conducted a meta-analysis in Cancer survivors (n=209,659). Healthiest combined lifestyle factors vs. Least healthy combined lifestyle factors was evaluated on All-cause mortality (HR 0.57, 95% CI 0.51-0.65). Cancer survivors with the healthiest combined lifestyle factors had a 43% lower risk of all-cause mortality compared to those with the least healthy lifestyles (HR 0.57).