Combined impact of inflammation, nutrition, and cardiovascular health on cancer survivor mortality: a retrospective NHANES cohort analysis (2005–2018)

BACKGROUND: Inflammation, nutritional status, and cardiovascular health are all correlated withmortality in cancer survivors, yet their combined effect remains unclear. RESEARCH DESIGN AND METHODS: We included 2,322 cancer survivors from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 cycles. The Advanced Lung Cancer Inflammation Index (ALI), reflecting inflammatory burden and nutritional status, and Life's Essential 8 (LE8), representing cardiovascular health, were categorized into tertiles and three-level groups, respectively. Survey-weighted multivariable Cox models estimated hazard ratios (HR) with 95% confidence intervals (CI). RESULTS: In multiple adjusted models, higher ALI was correlated with lower all-cause mortality (HR 0.63; 95% CI 0.47-0.84) and non-cancer mortality (HR 0.55; 95% CI 0.39-0.77). Similarly, elevated LE8 scores were linked to reduced risks of all-cause (HR 0.56; 95% CI 0.33-0.95) and non-cancer mortality (HR 0.39; 95% CI 0.22-0.67). Furthermore, high ALI was correlated with the lowest risk of all-cause mortality (HR, 0.38; 95% CI, 0.17-0.87) and non-cancer mortality (HR, 0.19; 95% CI, 0.06-0.56) death among cancer survivors who were high LE8 score. CONCLUSIONS: High ALI and LE8 together reduce all-cause and non-cancer mortality in cancer survivors, supporting combined nutritional-inflammatory and cardiovascular optimization for longer survival.