Abstract 6494: Postdiagnosis adherence to American Cancer Society cancer prevention guidelines and mortality among survivors of obesity-related cancers

Abstract

Abstract Purpose: To examine the combined and individual associations of postdiagnosis body mass index (BMI), physical activity, diet quality and alcohol consumption with all-cause mortality, cardiovascular disease mortality (CVDM) and cancer-specific mortality (CSM) among survivors of obesity-related cancers. Methods: American Cancer Society (ACS) Cancer Prevention Study-II Nutrition Cohort participants diagnosed with one of 13 invasive (but non-metastatic) obesity-related cancers between 1992 and 2003 were followed for mortality until 2018. Postdiagnosis lifestyle exposures were assessed at least one year after cancer diagnosis between 1999 and 2003. A lifestyle score ranging 0-8 was created according to adherence to the American Cancer Society (ACS) 2020 cancer prevention guidelines on BMI, physical activity, diet, and alcohol, with a score of 8 representing optimal behaviors for cancer prevention. Associations of the overall and individual component scores with mortality were estimated using multivariable-adjusted Cox proportional hazards regression models. Results: Among 7,945 cancer survivors, 4,862 died between 1992 and 2018. Higher ACS guideline score was associated with 6-8% lower risk of mortality per 1 point score increase (all-cause: HR: 0.94, 95% CI: 0.92-0.95; CVDM: HR:0.92, 95% CI:0.89-0.95; CSM: HR: 0.93, 95% CI 0.90-0.97) among cancer survivors. Individual scores of BMI, physical activity, and diet were inversely associated with overall mortality; however, alcohol score was positively associated with all-cause mortality, only among female survivors. Compared with participants who had low scores both before and after cancer diagnosis, those with high scores after diagnosis had lower risk of all-cause mortality, CVDM, and possibly CSM. Conclusion: Following ACS guidelines on diet and physical activity for cancer prevention after a cancer diagnosis is associated with better survival outcomes among survivors of obesity-related cancers. Citation Format: Ying Wang, Christina Newton, Marjorie L. McCullough, Lauren R. Teras, Erika Rees-Punia, Caroline Um, Alpa V. Patel. Postdiagnosis adherence to American Cancer Society cancer prevention guidelines and mortality among survivors of obesity-related cancers. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6494.