The Impact of Lifestyle-related Factors on Survival After a Prostate Cancer Diagnosis

Abstract

Research indicates that lifestyle-related factors such as obesity, physical activity, and smoking influence breast and colorectal cancer survival, but less is known about the association between lifestyle-related factors and survival in males with prostate cancer (PC). Recent reviews have investigated the impact of obesity on PC survival; however the small number of studies and significant heterogeneity in results make it difficult to draw firm conclusions [1]. Few studies have investigated the association between physical activity and PC survival [2]. More is known about tobacco smoking: a 2018 meta-analysis concluded that tobacco smoking at diagnosis is associated with poorer all-cause mortality (ACM) and PC-specific mortality (PSM) [3].

In this cohort study we investigated associations between obesity, physical activity, and smoking status at or before diagnosis and ACM and PSM among males diagnosed with PC. Participants were 572 men aged 40–75 yr (median 63 yr) diagnosed with PC in 2001–2002 in Western Australia (WA) who had previously taken part in a case-control study [4]. Participants self-reported their smoking status (current vs former vs never), height, weight, and recreational physical activity at or around the time of diagnosis. Date and cause of death were obtained via linkage to the WA Cancer and Death Registries. Follow-up was from PC diagnosis to date of death or censoring on February 17, 2017, whichever came first. The median follow-up was 15 yr (15 yr for participants who survived), and 193 participants died during follow-up (76 from PC). The Human Research Ethics Committee at the WA Department of Health and Curtin University approved this study.