Annual Meeting of the NCI Cohort Consortium (Abstract Submission): Submission #11

Lightning Talks Abstract
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Presenter's First Name: : Valeria









Presenter's Last Name:: Elahy









Title (eg: professor, assistant professor, chair, etc):: Postdoctoral Fellow









Degree(s): PhD









Contact Email:: valeria.elahy@cancer.org









Organization:: American Cancer Society









Project Title:: Post-diagnosis Adherence to American Cancer Society Guidelines and Mortality Among Prostate Cancer Patients in the Cancer Prevention Study-II Nutrition Cohort









Additional Authors:
1. First Name: Valeria
   Last Name: Elahy
   Degree(s): PhD
   Organization: American Cancer Society
2. First Name: Christina 
   Last Name: Newton
   Degree(s): MSPH
   Organization: American Cancer Society
3. First Name: Alpa
   Last Name: Patel
   Degree(s): PhD
   Organization: American Cancer Society
4. First Name: Marji
   Last Name: McCullough
   Degree(s): ScD, RD
   Organization: American Cancer Society
5. First Name: Lauren
   Last Name: Teras
   Degree(s): PhD
   Organization: American Cancer Society
6. First Name: Clara
   Last Name: Bodelon
   Degree(s): PhD
   Organization: American Cancer Society
7. First Name: Caroline
   Last Name: Um
   Degree(s): PhD, MPH, RD
   Organization: American Cancer Society
8. First Name: Erika
   Last Name: Rees-Punia
   Degree(s): PhD, MPH
   Organization: American Cancer Society
9. First Name: Laura
   Last Name: Mararoff
   Degree(s): DO
   Organization: American Cancer Society
10. First Name: Ying
    Last Name: Wang
    Degree(s): PhD, MS
    Organization: American Cancer Society










Abstract::
Purpose: The American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Survivors recommend avoiding obesity, engaging in regular physical activity, following a healthy diet, and limiting alcohol intake. This study aimed to assess the association between adherence to these guidelines and all-cause mortality, cardiovascular disease mortality (CVDM), and prostate cancer-specific mortality (PCSM) among prostate cancer patients and to explore whether the association varies by tumor aggressiveness.

Methods: Data from 4,232 prostate cancer patients in the Cancer Prevention Study-II Nutrition Cohort were analyzed. Adherence to ACS guidelines was scored (0-8), with higher scores indicating greater adherence. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were calculated using Cox proportional hazards regression models. 

Results: Higher ACS guideline score was associated with lower risk of all-cause mortality (HR for score 6-8 vs. 0-3: 0.77; 95% CI, 0.69 to 0.85), CVDM (HR: 0.75; 95% CI, 0.63 to 0.91), and PCSM (HR: 0.79; 95% CI, 0.60 to 1.03). Among patients with non-aggressive tumors, higher adherence was associated with significantly lower all-cause mortality (HR: 0.78; 95% CI, 0.70 to 0.87) and CVDM (HR: 0.79; 95% CI, 0.65 to 0.98) but not PCSM. A higher score was associated with lower all-cause mortality (HR: 0.75; 95% CI, 0.58 to 0.95) but not CVDM or PCSM among men with aggressive tumors. 

Conclusion: Adherence to ACS guidelines was associated with lower all-cause mortality and CVDM in prostate cancer patients, particularly those with non-aggressive tumors. These findings emphasize the potential benefit of post-diagnosis lifestyle modifications.