Combined lifestyle factors, incident cancer, and cancer mortality: a systematic review and meta-analysis of prospective cohort studies

Abstract

Background Cancer poses a huge disease burden, which could be reduced by adopting healthy lifestyles mainly composed of healthy diet, body weight, physical activity, limited alcohol consumption, and avoidance of smoking. However, no systematic review has summarised the relations of combined lifestyle factors with cancer morbidity and mortality. Methods EMBASE and PubMed were searched up to April 2019. Cohort studies investigating the association of combined lifestyle factors with risks of incident cancer and cancer mortality were selected. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity and publication bias tests were conducted. Results The HRs (95% CIs) comparing individuals with the healthiest versus the least healthy lifestyles were 0.71 (0.66–0.76; 16 studies with 1.9 million participants) for incident cancer and 0.48 (0.42–0.54; 30 studies with 1.8 million participants) for cancer mortality. Adopting the healthiest lifestyles was also associated with 17 to 58% lower risks of bladder, breast, colon, endometrial, oesophageal, kidney, liver, lung, rectal, and gastric cancer. The relations were largely consistent and significant among participants with different characteristics in the subgroup analyses. Conclusions Adopting healthy lifestyles is associated with substantial risk reduction in cancer morbidity and mortality, and thus should be given priority for cancer prevention.

Lifestyle risk score and mortality in Korean adults: a population-based cohort study

“…Some of our analyses did not have enough power to detect significant results. Especially, our null finding for cancer mortality, which is contrary to previous studies that showed an inverse association between healthy lifestyles and cancer mortality 36 , can be due to limited follow-up time and number of cancer deaths, or by chance and thus should be interpreted with caution. More prospective studies with longer follow-up period are needed to reexamine cause-specific mortality in this population.…”

Sex and Survival After Surgery for Lung Cancer

“…Factors such as more aggressive treatment regimens in younger patients and lifestyle choices, before and after an early diagnosis of lung cancer, may influence survival. 32,33 Life expectancy is affected by smoking patterns in the general population, and tobacco smoking is one of the most important risk factors of disease burden and mortality. [34][35][36] In the present cohort, women more often were never smokers, whereas men were more likely to be former smokers, which is in accord with previous reports.…”

“…Factors such as more aggressive treatment regimens in younger patients and lifestyle choices, before and after an early diagnosis of lung cancer, may influence survival. 32 , 33 …”

Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: two prospective cohort studies

“…Thus, the healthy lifestyle score was the sum of the points and ranged between 0 and 4, with higher scores indicating healthier lifestyles. Although this simple additive method has been used widely,303132 the underlying assumption is that the associations between different lifestyle factors and the outcome were identical, which might not be true. Thus we also constructed a weighted lifestyle score, where each lifestyle factor was weighted by its association with the outcome.…”