Associations of combined healthy lifestyles with cancer morbidity and mortality among individuals with diabetes

Cancer has contributed to an increasing proportion of diabetes-related deaths, while lifestyle management is the cornerstone of both diabetes care and cancer prevention. A research team evaluated the associations of combined healthy lifestyles with total and site-specific cancer risks among individuals with diabetes.
92,239 individuals with diabetes but without cancer at baseline were included in the study from five population-based cohorts in the USA (National Health and Nutrition Examination Survey and National Institutes of Health [NIH]-AARP Diet and Health Study), the UK (UK Biobank study) and China (Dongfeng-Tongji cohort and Kailuan study). Healthy lifestyle scores (range 0-5) were constructed based on current nonsmoking, low-to-moderate alcohol drinking, adequate physical activity, healthy diet and optimal bodyweight. HRs for cancer morbidity and mortality, adjusting for sociodemographic, medical and diabetes-related factors, were calculated.
During 376,354 person-years of follow-up from UK Biobank and the two Chinese cohorts, 3,229 incident cancer cases were documented, and 6,682 cancer deaths were documented during 1,089,987 person-years of follow-up in the five cohorts. HRs (95% CIs) comparing participants with 4-5 vs 0-1 healthy lifestyle factors were 0.73 (0.61, 0.88) for incident cancer and 0.55 (0.46, 0.67) for cancer mortality, and ranged between 0.41 and 0.63 for oesophagus, lung, liver, colorectum, breast and kidney cancers. Findings remained consistent across different cohorts and subgroups.
This international cohort study found that adherence to combined healthy lifestyles was associated with lower risks of total cancer morbidity and mortality as well as several subtypes (oesophagus, lung, liver, colorectum, breast and kidney cancers) among individuals with diabetes.
Source: Zhang YB, Pan XF, Lu Q, Wang YX, Geng TT, Zhou YF, Liao LM,et al.. Associations of combined healthy lifestyles with cancer morbidity and mortality among individuals with diabetes: results from five cohort studies in the USA, the UK and China. Diabetologia. 2022 Sep 14. doi.org/10.1007/s00125-022-05754-x.