Longitudinal associations of adherence to lifestyle recommendations and health‐related quality of life in patients with non‐muscle invasive bladder cancer

• Published in: International journal of cancer Vol. 152; no. 10; pp. 2032 - 2042
• Main Authors: Vidra, Nikoletta, Beeren, Ivy, Zutphen, Moniek, Aben, Katja K., Kampman, Ellen, Witjes, J. Alfred, Heijden, Antoine G., Kiemeney, Lambertus A., Vrieling, Alina
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 15.05.2023; Wiley Subscription Services, Inc
• Subjects: Bladder cancer; Body mass index; Cancer; Cancer research; cancer survivors; Diet; health‐related quality of life; Humans; Invasiveness; Life Style; Lifestyles; Medical research; Non-Muscle Invasive Bladder Neoplasms; non‐muscle invasive bladder cancer; Physical activity; Prospective Studies; Quality of Life; United States; Urinary Bladder Neoplasms; WCRF/AICR; United States; WCRF/AICR; non-muscle invasive bladder cancer; health-related quality of life; diet; cancer survivors
• ISSN: 0020-7136; 1097-0215; 1097-0215
• DOI: 10.1002/ijc.34418

Although the role of lifestyle in health‐related quality of life (HRQoL) outcomes has been increasingly recognized for various types of cancer, evidence in patients with non‐muscle invasive bladder cancer (NMIBC) is very limited. We aimed to evaluate the longitudinal association between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations and HRQoL in patients with NMIBC. This study included 1029 patients with NMIBC recruited between May 2014 and April 2017 from the Dutch multi‐centre prospective cohort study UroLife. Lifestyle and HRQoL data were collected at 6 weeks (baseline), 3 months and 15 months after diagnosis. Information on body mass index (BMI), physical activity, diet and alcohol was used to compute the standardized WCRF/AICR adherence score (0‐7). HRQoL outcomes were evaluated by the EORTC QLQ‐C30. Linear mixed models were used to assess longitudinal confounder‐adjusted associations between the WCRF/AICR adherence score and HRQoL outcomes. Adherence to each additional WCRF/AICR recommendation was associated with better global quality of life, physical, role and social functioning, and less fatigue. We found stronger inter‐individual than intra‐individual associations, suggesting that associations were mainly driven by between‐subject differences. Higher adherence to the BMI, physical activity and dietary recommendations was associated with better scores for most HRQoL outcomes, while adherence to the alcohol recommendation (ie, non‐consumption) was associated with worse HRQoL. Following the WCRF/AICR lifestyle recommendations may improve HRQoL in patients with NMIBC. Intervention studies are needed to establish whether the association between lifestyle and HRQoL is causal. What's new? While lifestyle factors have been cross‐sectionally associated with health‐related quality of life (HRQoL) among patients with non‐muscle invasive bladder cancer (NMIBC), associations between overall healthy lifestyle and HRQoL in the year after diagnosis remain unclear. In this study, longitudinal associations between HRQoL and adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations were examined in patients with NMIBC in the Netherlands. Higher adherence to WCRF/AICR recommendations for body mass index, physical activity and diet was linked to improved HRQoL. Meanwhile, worse HRQoL was related to abstinence from alcohol. The findings warrant further investigation to assess potential causative links between lifestyle and HRQoL.