Cancer and all-cause mortality among United States union poultry workers.

Previous studies link marital status to mortality across diverse populations. This study examines how sex influences its association with all-cause, cardiovascular disease (CVD), and cancer mortality. The search was conducted through PubMed, Scopus, and Google Scholar databases and included related articles up to September 16, 2025. The titles, abstracts, and full texts of the included articles were reviewed, and data were extracted and analyzed. Twelve cohort studies (1,785,857 individuals) were analyzed. Unmarried status was significantly associated with an increased risk of all-cause, CVD, and cancer mortality. Specifically, single individuals showed a higher risk of all-cause (hazard ratio [HR]: 1.55, 95% CI: 1.37-1.74), cancer (HR: 1.14, 95% CI: 1.07-1.22), and CVD mortality (HR: 1.52, 95% CI: 1.28-1.84). Divorced individuals had an increased risk of all-cause (HR: 1.39, 95% CI: 1.12-1.66) and CVD mortality (HR: 1.27, 95% CI: 1.02-1.52). Widowed individuals showed a higher risk of all-cause (HR: 1.43, 95% CI: 1.11-1.74), cancer (HR: 1.13, 95% CI: 1.03-1.23), and CVD mortality (HR: 1.67, 95% CI: 1.23-2.10). Unmarried status is significantly associated with an increased risk of all-cause, cancer, and CVD mortality. The association between marital status and mortality differs by sex and geographic region. For instance, the link between divorced status and all-cause mortality is significantly stronger in men, while the association between single status and cancer mortality is significantly stronger in women. These findings highlight the importance of considering sex and regional differences in public health interventions.

Background: Insulin-like Growth Factor Binding Protein 7 (IGFBP7) may modulate IGF signaling and influence non-IGF molecular mechanisms. We analyzed whether IGFBP7 concentration in plasma is associated with risk of cancer incidence, cancer mortality, and all-cause mortality. Methods: We conducted a prospective cohort analysis of 10, 834 participants (54.8% female, 24.3% Black) with no cancer history for cancer incidence and mortality analyses, and 11, 761 participants (55.6% female, 23.6% Black) for the all-cause mortality analysis in the Atherosclerosis Risk in Communities study. The median follow-up time was 22.8, 23.5, and 25.6 years for the respective analyses. Participants were aged 46-70 years old at start of follow-up. Plasma IGFBP7 was measured using SomaScan® 5K assay, an aptamer-based technology for protein profiling. Incident cancer diagnoses were ascertained by state cancer registry linkage supplemented with medical records and death certificates. Mortality was ascertained by death certificates, including via the National Death Index. We estimated the association between IGFBP7 plasma levels (log2transformed) and outcomes including cancer incidence, cancer mortality, and all-cause mortality using Cox proportional hazards regression models adjusting for age, sex, race, and other potential risk factors for cancer and/or mortality. Results: The association between IGFBP7 and total cancer incidence (3, 347 cases, 200, 279 person-years) was null (HR=0.99, 95% CI 0.85-1.16). However, IGFBP7 was positively associated with lung cancer incidence (479 cases, 199, 823 person-years; HR=1.40, 95% CI 0.93-2.10), unlike for other common cancer sites. The association between IGFBP7 and total cancer mortality (1, 420 deaths, 222, 320 person-years) was statistically significant (HR=1.39, 95% CI 1.10-1.76). Of the common cancers, IGFBP7 was positively associated with lung cancer mortality (HR=1.69, 95% CI 1.10-2.60) and breast cancer mortality (HR=2.09, 95% CI 0.88-4.97). The association between IGFBP7 and all-cause mortality (6, 981 deaths, 262, 734 person-years) was statistically significant and the strongest among the three main analyses (HR=1.72, 95% CI 1.55-1.91). Stratifying by age, the strongest association between IGFBP7 and all-cause mortality was in the youngest age quartile (ages 46.9-52.6 years; HR=2.69, 95% CI 2.01-3.59). IGFBP7 is not strongly correlated with IGF-1 and other family proteins. Conclusions: High circulating IGFBP7 levels may be a risk factor for cancer and all-cause mortality, especially among those in middle adulthood. High circulating IGFBP7 levels may also be a risk factor for both lung cancer incidence and mortality. Additional research and laboratory testing will be necessary to determine whether IGFBP7’s influence on IGF signaling or other mechanisms contribute to tumor progression and mortality, in general. Support: NHLBI, NCI, NPCR Citation Format: Vernon A. Burk, Michael N. Pollak, Corinne E. Joshu, Anna Prizment, Elizabeth A. Platz. The association between plasma IGFBP7 and cancer incidence, cancer mortality, and all-cause mortality in ARIC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4936.

ObjectiveTo investigate the association of serum creatinine-cystatin C ratio (Cr/CysC) with long-term all-cause mortality and cause-specific (cardiovascular and cancer) mortality among US general adults.MethodsThis nationally representative cohort study included adults in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. Participants were linked to National Death Index data from the survey date through December 31, 2019. Weighted Cox proportional hazards regression models were used to calculate hazard ratios and 95% confidence intervals (CIs), and restricted cubic splines and stratified analyses were also performed.ResultsA total of 12,914 participants were included in this study (mean [SD] age, 45.3 [17.3] years; males, 48.9%). During a median follow-up of 17.9 years (maximum follow-up, 20.8 years), 3439 total deaths occurred, including 1098 cardiovascular deaths and 736 cancer deaths. Cumulative incidence curves revealed that increased Cr/CysC ratio had lower risk of all-cause (P < 0.001), cardiovascular (P < 0.001) and cancer (P < 0.001) mortality. Cox regression an Fine-Gray hazards models demonstrated that the multivariable-adjusted hazard ratios comparing the highest vs. lowest quartile of Cr/CysC ratio were 0.40 (95% CI, 0.34–0.47; P < 0.001) for all-cause mortality, 0.68 (95% CI, 0.52–0.88; P < 0.001) for cardiovascular mortality, and 0.51 (95% CI, 0.36–0.71; P < 0.001) for cancer mortality. Nonlinear association was observed for Cr/CysC ratio and all-cause mortality (P = 0.018 for nonlinearity), and linear associations were observed for Cr/CysC ratio and cardiovascular (P = 0.212 for nonlinearity) and cancer (P = 0.550 for nonlinearity) mortality. Besides, a series of sensitivity analyses ensured the robustness of the results.ConclusionsIn this cohort of US adults, Cr/CysC ratio was negatively associated with all-cause, cardiovascular, and cancer mortality. Our study suggests that Cr/CysC ratio may serve as a simple and effective predictor of long-term health outcomes.

Joint association of frailty index and biological aging with all-cause and cause-specific mortality: a population-based longitudinal cohort study.

Background: advanced glycation end-products (AGEs), formed through a series of non-enzymatic reactions, can promote inflammation and oxidative stress. Their accumulation in the body has been linked to cardiovascular disease (CVD) and cancer. However, the association of total AGEs and AGEs from different food sources with risks of all-cause, CVD, and cancer mortality is still unknown. Methods: we conducted a prospective cohort study of a nationally representative sample of 22 124 participants from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES 2003-2006. A food frequency questionnaire (FFQ) was utilized to calculate total and different food-derived AGE intake. Associations between various dietary AGE scores and the risk of all-cause, CVD, and cancer mortality were assessed by weighted Cox proportional hazard regression models. Results: over a median follow-up period of 27.1 years, we found that in the general population, AGE scores of both baked foods and meat were risk factors for all-cause, CVD, and cancer mortality. Specially, higher AGE scores in total and those derived from 10 of the 13 food groups were statistically associated with an increased risk of CVD mortality. Egg-, fruit-, and vegetable-derived AGE scores were positively correlated with the risk of cancer mortality. Additionally, there were positive multiplicative and additive interactions between smoking and meat-derived AGE scores on all-cause mortality. Conclusions: high amounts of AGE consumption is associated with an increased risk of CVD mortality, and meat and baked food-derived AGEs were positively linked to all-cause, CVD, and cancer mortalities. Adherence to unhealthy lifestyles, such as smoking, may increase mortality from leading causes in individuals with AGE-enriched diet habits.

We aimed to summarize the associations between food sources of fructose and cardiovascular diseases (CVD), cancer, and all-cause mortality risk using a systematic review and meta-analysis. We searched PubMed, Scopus, and Web of Science up to November 2020. We included cohort studies that investigated the relationship between mortality risk (all-cause, CVD, specific CVD, and total and site-specific cancers) and intake of ≥1 food source of fructose (fruit, fruit juice, breakfast cereals, sugar-sweetened beverages (SSBs), sweets, and yogurt) in general adult population. Summary hazard ratios and 95% CIs were estimated using a random-effects model for linear and nonlinear relationships. Findings indicated that each 100 g/d increase in fruit intake was associated with 8-13% lower risk of CVDs, stroke, gastrointestinal, and lung cancer mortality. For all-cause mortality, there was a beneficial relationship up to 200 g/d fruit, and then plateaued. For ischemic heart disease and cancer mortality, there was a beneficial relationship up to 300 g/d followed by a slight increase. Ingestion of breakfast cereals and sweets was also associated with lower risk of all-cause mortality. For yogurt, a non-linear marginal decrease in all-cause mortality was found. Ingestion of each 200 g/d yogurt was associated with a 14% lower risk of CVD mortality. Every 60 g/d increase in sweet intake was linked to a 5% lower risk of all-cause mortality. Contrariwise, every 250 g/d increase in SSBs intake was associated with 7–10% higher risk of all-cause and CVD mortality. In conclusion, beneficial associations were found between fruit, breakfast cereals, sweets, and yogurt with all-cause and/or CVD mortality risk. Fruit intake had also an inverse link with cancer mortality. Conversely, SSBs had a harmful relationship with all-cause and CVD mortality. Registry number: CRD42019144956

Fruit, vegetable, and legume intake and the risk of all-cause, cardiovascular, and cancer mortality: A prospective study

High red meat intake and all-cause cardiovascular and cancer mortality: is the risk modified by fruit and vegetable intake?

Asia has experienced a large increase in meat intake in the past decade, yet the health impact of meat intake is not well studied. We examined the association of meat intake with all-cause, cancer and cardiovascular disease (CVD) mortality in an Asian country. Participants were 113,568 adults with dietary data at recruitment (2004-2013) of the Health Examinees-Gem (HEXA-G) study, a prospective cohort study conducted in 8 regions of Korea. Participants were followed until 31 December 2020. Total, red, white, and organ meat intake were computed based on a 106-item questionnaire. Multivariable Cox proportional hazard models were implemented using the lowest quintile of meat intake as the reference category. For 1,205,236 person-years, 3,454 deaths were recorded. High intake of processed red meat was positively associated with all-cause mortality [men: hazard ratio (HR) 1.21, 95% confidence interval (95% CI) 1.07-1.37; women: HR 1.32, 95% CI 1.12-1.56]. Increased risk of all-cause mortality (HR 1.21, 95% CI 1.05-1.39) and cancer mortality (HR 1.24, 95% CI 1.03-1.50) was observed in women with high intake of organ meat. Moderate intake of pork belly was associated with reduced risk of all-cause mortality in men (HR 0.76, 95% CI 0.62-0.93) and women (HR 0.83, 95% 0.69-0.98) but high intake was associated with increased risk of CVD mortality in women (HR 1.84, 95% CI 1.20-2.82). Low beef intake decreased the risk of CVD mortality in men (HR 0.58, 95% CI 0.40-0.84), but roasted pork increased cancer mortality in women (HR 1.26, 95% CI 1.05-1.52). There was increased risk of all-cause mortality associated with intake of processed red meat in men and women, increased risk of all-cause and cancer mortality with intake of organ meat in women, and increased risk of cancer mortality with intake of roasted pork intake in women. High intake of pork belly increased the risk of CVD mortality in women, but moderate intake was inversely associated with mortality from all-causes in both men and women.

Association of phthalate exposure with all-cause and cause-specific mortality among people with hypertension: The U.S. National Health and Nutrition Examination Survey, 2003–2014

&lt;div&gt;Abstract&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Little is known regarding the role of early-life exercise, a potentially modifiable factor, in long-term adult morbidity and mortality. We utilized the Shanghai Women's Health Study (SWHS) to investigate adolescent exercise in association with cancer, cardiovascular disease (CVD), and all-cause mortality among middle-aged and older women.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; The SWHS is a prospective cohort of 74,941 Chinese women ages 40 to 70 years recruited from 1996 to 2000. In-person interviews at enrollment assessed adolescent and adult exercise history, medical and reproductive history, and other lifestyle and socioeconomic (SES) factors. Mortality follow-up occurs via annual linkage to the Shanghai Vital Statistics Registry. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were derived from Cox regression models.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; Adjusting for birth year and other adolescent factors, adolescent exercise was associated with reduced risk of cancer, CVD, and total mortality [HRs (95% CI), 0.83 (0.72–0.95), 0.83 (0.70–0.98), and 0.78 (0.71–0.85), respectively for ≤1.33 hours (h)/week, and 0.83 (0.74–0.93), 0.62 (0.53–0.72), and 0.71 (0.66–0.77), respectively for &gt;1.33 h/week (reference = none)]. Results were attenuated after adjustment for adult SES and lifestyle factors. Participation in sports teams was inversely associated with cancer mortality [HR (95% CI), 0.86 (0.76–0.97)]. Joint adolescent and adult exercise was associated with reduced risk of all-cause, CVD, and cancer mortality [HRs (95% CIs), 0.80 (0.72–0.89), 0.83 (0.69–1.00), and 0.87 (0.74–1.01), respectively], adjusting for adult/adolescent factors, and adolescence exercise only was inversely associated with cancer mortality [HR (95% CI), 0.84 (0.71–0.98)].&lt;/p&gt;&lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Adolescent exercise participation, independent of adult exercise, was associated with reduced risk of cancer, CVD, and all-cause mortality.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Impact:&lt;/b&gt; Results support promotion of exercise in adolescence to reduce mortality in later life. &lt;i&gt;Cancer Epidemiol Biomarkers Prev; 24(8); 1270–6. ©2015 AACR&lt;/i&gt;.&lt;/p&gt;&lt;/div&gt;

&lt;div&gt;Abstract&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Little is known regarding the role of early-life exercise, a potentially modifiable factor, in long-term adult morbidity and mortality. We utilized the Shanghai Women's Health Study (SWHS) to investigate adolescent exercise in association with cancer, cardiovascular disease (CVD), and all-cause mortality among middle-aged and older women.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; The SWHS is a prospective cohort of 74,941 Chinese women ages 40 to 70 years recruited from 1996 to 2000. In-person interviews at enrollment assessed adolescent and adult exercise history, medical and reproductive history, and other lifestyle and socioeconomic (SES) factors. Mortality follow-up occurs via annual linkage to the Shanghai Vital Statistics Registry. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were derived from Cox regression models.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; Adjusting for birth year and other adolescent factors, adolescent exercise was associated with reduced risk of cancer, CVD, and total mortality [HRs (95% CI), 0.83 (0.72–0.95), 0.83 (0.70–0.98), and 0.78 (0.71–0.85), respectively for ≤1.33 hours (h)/week, and 0.83 (0.74–0.93), 0.62 (0.53–0.72), and 0.71 (0.66–0.77), respectively for &gt;1.33 h/week (reference = none)]. Results were attenuated after adjustment for adult SES and lifestyle factors. Participation in sports teams was inversely associated with cancer mortality [HR (95% CI), 0.86 (0.76–0.97)]. Joint adolescent and adult exercise was associated with reduced risk of all-cause, CVD, and cancer mortality [HRs (95% CIs), 0.80 (0.72–0.89), 0.83 (0.69–1.00), and 0.87 (0.74–1.01), respectively], adjusting for adult/adolescent factors, and adolescence exercise only was inversely associated with cancer mortality [HR (95% CI), 0.84 (0.71–0.98)].&lt;/p&gt;&lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Adolescent exercise participation, independent of adult exercise, was associated with reduced risk of cancer, CVD, and all-cause mortality.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Impact:&lt;/b&gt; Results support promotion of exercise in adolescence to reduce mortality in later life. &lt;i&gt;Cancer Epidemiol Biomarkers Prev; 24(8); 1270–6. ©2015 AACR&lt;/i&gt;.&lt;/p&gt;&lt;/div&gt;

Little is known regarding the role of early-life exercise, a potentially modifiable factor, in long-term adult morbidity and mortality. We utilized the Shanghai Women's Health Study (SWHS) to investigate adolescent exercise in association with cancer, cardiovascular disease (CVD), and all-cause mortality among middle-aged and older women. The SWHS is a prospective cohort of 74,941 Chinese women ages 40 to 70 years recruited from 1996 to 2000. In-person interviews at enrollment assessed adolescent and adult exercise history, medical and reproductive history, and other lifestyle and socioeconomic (SES) factors. Mortality follow-up occurs via annual linkage to the Shanghai Vital Statistics Registry. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were derived from Cox regression models. Adjusting for birth year and other adolescent factors, adolescent exercise was associated with reduced risk of cancer, CVD, and total mortality [HRs (95% CI), 0.83 (0.72-0.95), 0.83 (0.70-0.98), and 0.78 (0.71-0.85), respectively for ≤1.33 hours (h)/week, and 0.83 (0.74-0.93), 0.62 (0.53-0.72), and 0.71 (0.66-0.77), respectively for >1.33 h/week (reference = none)]. Results were attenuated after adjustment for adult SES and lifestyle factors. Participation in sports teams was inversely associated with cancer mortality [HR (95% CI), 0.86 (0.76-0.97)]. Joint adolescent and adult exercise was associated with reduced risk of all-cause, CVD, and cancer mortality [HRs (95% CIs), 0.80 (0.72-0.89), 0.83 (0.69-1.00), and 0.87 (0.74-1.01), respectively], adjusting for adult/adolescent factors, and adolescence exercise only was inversely associated with cancer mortality [HR (95% CI), 0.84 (0.71-0.98)]. Adolescent exercise participation, independent of adult exercise, was associated with reduced risk of cancer, CVD, and all-cause mortality. Results support promotion of exercise in adolescence to reduce mortality in later life.

Despite a growing body of research indicating a link between fasting glucose levels and mortality, the relationship between fasting glucose and all-cause and cancer mortality remains inconsistent. In this study, we used Cox regression and restricted cubic spline models to analyze the association and dose-response relationship between fasting plasma glucose levels and all-cause and cancer mortality in a retrospective cohort based on data from the 2015 health check-ups of residents in Quzhou City. After a mean follow-up of 5.31 years for 148,755 study participants, 10,345 deaths occurred, with an all-cause mortality density of 131.09/10,000 person-years, of which 2,845 were cancer deaths, with a cancer mortality density of 36.05/10,000 person-years. There was a "J" shaped dose-response relationship between fasting plasma glucose levels and all-cause and cancer mortality. Relative to normal fasting glucose (NFG), the risk of all-cause mortality (HRs and 95% CIs) in the impaired fasting glucose (IFG) and diabetes mellitus (DM) groups was 1.11 (1.06, 1.16) and 1.43 (1.35, 1.52), respectively, and the risk of cancer mortality in the DM group was 1.22 (1.09, 1.37). In this cohort study, we found that fasting plasma glucose levels were significantly associated with the risk of all-cause and cancer mortality.

PurposeThe aim of this study was to investigate the joint association of systemic inflammatory response index (SIRI) and sarcopenia with cancer-specific and all-cause mortality in individuals with self-reported cancer.MethodsThe study cohort comprised individuals with a self-reported cancer diagnosis from the NHANES database, with data collected between 1999 and 2006 and 2011–2018. The researchers tracked deaths up to 31 December 2019 by linking the relevant records to those held by the (NDI). A weighted sampling design was employed, with participants stratified according to the median value of the SIRI. Cox regression models were employed to assess the association between SIRI, sarcopenia, all-cause mortality, and cancer-specific mortality.ResultsThe study cohort comprised 1316 individuals with self-reported cancer. Over a median follow-up period of 9.21 years, 523 all-cause deaths were recorded, including 163 cancer-specific and 360 non-cancer deaths. Adjusting for multiple confounders, elevated SIRI levels were significantly associated with increased risks of all-cause (HR = 1.90 [1.58–2.28]), cancer (HR = 1.88 [1.26–2.78]), and non-cancer mortality (HR = 1.93 [1.54–2.41]). Sarcopenia also emerged as a significant predictor of mortality. Individuals with sarcopenia faced a 50% higher risk of all-cause mortality (HR = 1.50 [1.18–1.91]) and a 54% higher risk of non-cancer mortality (HR = 1.54 [1.11–2.12]). However, the association with cancer mortality was not significant in the fully adjusted model. When both sarcopenia and elevated SIRI were present, the risk was the highest for all-cause (HR = 2.54 [1.92–3.37]), cancer (HR = 2.29 [1.19–4.40]), and non-cancer mortality (HR = 2.63 [1.78–3.89]). Elevated SIRI alone was linked to significant risks for all-cause (HR = 1.91 [1.51–2.42]), cancer (HR = 1.95 [1.28–2.97]), and non-cancer mortality (HR = 1.92 [1.46–2.53]). Sarcopenia alone significantly increased the risk of all-cause mortality (HR = 1.63 [1.01–2.56]) but not cancer mortality.ConclusionOur study is the first to demonstrate the joint association between the SIRI and sarcopenia with mortality among individuals with self-reported cancer. These findings underscore the importance of assessing and managing these two factors in individuals with self-reported cancer to reduce the risk of death and improve survival outcomes.