Healthier Lifestyle Linked to Lower Risk for Cancer Death



Cancer survivors who adhere to a healthy lifestyle, which includes never smoking, light alcohol intake, sufficient physical activity, a healthy diet, and an optimal body mass index (BMI), may lower their risk for cancer-related and all-cause mortality.


  • Cancer survivors often face long-term health problems and reduced quality of life. While modifiable risk factors can affect cancer survival, the specific influence of adopting a healthy lifestyle on overall cancer survival is still uncertain.
  • Researchers in this study examined five lifestyle factors (BMI, cigarette smoking, alcohol drinking, diet, and physical activity) in 37,095 cancer survivors from the United States, the United Kingdom, and China.
  • A total of 18,990 cancer survivors reported never smoking, 14,768 reported light alcohol consumption, 17,260 reported a healthy diet, 18,141 reported adequate physical activity, and 14,739 reported an optimal BMI.
  • Healthy lifestyle scores were created by summing these factors, ranging from 0 to 5, with higher scores indicating a healthier lifestyle.
  • During follow-up, 4449 cancer deaths and 8927 all-cause mortality events occurred.


  • Adherence to a healthy lifestyle (4-5 healthy lifestyle factors) vs an unfavorable lifestyle (0-1 healthy lifestyle factor) was associated with a 43% reduction in the risk for cancer-related mortality (hazard ratio [HR], 0.57) and a 48% reduction in the risk for all-cause mortality (HR, 0.52).
  • Each point gained in the healthy lifestyle score resulted in an 18% reduction in the risk for cancer-related as well as all-cause mortality (both adjusted HRs, 0.82).
  • Eating a healthy diet contributed the most to the reduction of mortality risk by 31%, followed by never smoking (23%), light alcohol consumption (14%), optimal BMI (11%), and adequate physical activity (1%). Similar reductions were seen in all-cause mortality.
  • The associations between the healthy lifestyle score and mortality were consistent in subgroups based on sociodemographic and cancer-related factors.


“Consistently, our study showed that the premature death risk was ~50% lower in those with a healthy lifestyle compared to those without, which further illustrated that lifestyle modifications are instrumental in improving the prognosis of cancer survivors,” the authors concluded.


This study, led by Zilong Bian from the School of Public Health and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China, was published online on January 17, 2024, in the International Journal of Cancer.


The exposure definitions varied across four cohorts, lifestyle data were collected only at baseline, and any potential changes during follow-up were not accounted for. Also, detailed cancer-related information was lacking.


This research was supported by Natural Science Fund for the National Nature Science Foundation of China, the Distinguished Young Scholars of Zhejiang Province, Traditional Chinese Medicine Science and Technology Plan of Zhejiang Province, National Natural Science Foundation of China, CRUK Career Development Fellowship, the Swedish Heart Lung Foundation, the Swedish Research Council, and the Swedish Research Council for Health, Working Life and Welfare. The authors declared no conflict of interest.


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