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A healthy lifestyle and survival among women with ovarian cancer
Author(s) -
Hansen Jessy M.,
Nagle Christina M.,
Ibiebele Torukiri I.,
Grant Peter T.,
Obermair Andreas,
Friedlander Michael L.,
DeFazio Anna,
Webb Penelope M.
Publication year - 2020
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.33155
Subject(s) - medicine , hazard ratio , confidence interval , proportional hazards model , national death index , gynecology , cohort , cohort study , ovarian cancer , lower risk , cancer , demography , sociology
Ovarian cancer has a poor survival rate and, understandably, women often want to know whether there is anything they can do to improve their prognosis. Our goal was to investigate the association between a healthy lifestyle prediagnosis and postdiagnosis and survival in a cohort of Australian women with invasive epithelial ovarian cancer. We calculated a healthy lifestyle index (HLI) based on women's self‐reported smoking status, height, weight, physical activity, diet and alcohol consumption before diagnosis (n = 678) and after completing primary treatment (n = 512). Clinical data and vital status for each woman were ascertained through medical records. Cox proportional hazards regression was conducted to calculate hazard ratios (HR) and 95% confidence interval (CI) for all‐cause mortality. There was a suggestive association between a more healthy lifestyle before diagnosis and better survival (HR 0.79, 95% CI: 0.59‐1.04), however, the association was stronger for lifestyle after diagnosis, with women in the highest tertile having significantly better survival than women in the lowest tertile (HR 0.61, 95% CI: 0.40‐0.93; P ‐trend = .02). Current smoking, particularly postdiagnosis, was associated with higher mortality (HR 1.68, 95% CI: 1.17‐2.42; HR 2.82, 95% CI: 1.29‐6.14, for prediagnosis and postdiagnosis smoking, respectively), but women who quit after diagnosis had survival outcomes similar to nonsmokers (HR 0.99, 95% CI: 0.57‐1.72). Higher physical activity after diagnosis was associated with better survival (HR 0.60, 95% CI: 0.39‐0.92; P ‐trend = .02). A healthy lifestyle after diagnosis, in particular not smoking and being physically active, may help women with ovarian cancer improve their prognosis.