Healthier lifestyle linked to lower risk of cancer death


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


  • Cancer survivors often face long-term health problems and reduced quality of life. Although modifiable risk factors may affect cancer survival, the specific influence of adopting a healthy lifestyle on overall cancer survival remains unclear.
  • Researchers in this study looked at five lifestyle factors (BMI, smoking, alcohol consumption, diet, and physical activity) among 37,095 cancer survivors in the United States, United Kingdom, and China.
  • A total of 18,990 cancer survivors reported never smoking, 14,768 reported light alcohol use, 17,260 reported healthy eating, 18,141 reported adequate physical activity, and 14,739 reported 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, 4,449 cancer deaths and 8,927 all-cause mortality events occurred.


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


“Consistently, our study showed that the risk of premature death was approximately 50% lower among people with a healthy lifestyle compared to those who did not, further illustrating that changes lifestyle changes play a key role in improving the prognosis of cancer survivors,” the authors concluded.


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


Exposure definitions varied between four cohorts, lifestyle data were only collected at baseline, and any potential changes during follow-up were not considered. Additionally, detailed information about cancer was missing.


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

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