A healthy lifestyle and survival among women with ovarian cancer. Issue 12 (6th July 2020) - Hansen, Jessy M.
Abstract: Ovarian cancer has a poor survival rate and, understandably, women often want to know whether there is anything they can do to improve their prognosis. Our goal was to investigate the association between a healthy lifestyle prediagnosis and postdiagnosis and survival in a cohort of Australian women with invasive epithelial ovarian cancer. We calculated a healthy lifestyle index (HLI) based on women's self‐reported smoking status, height, weight, physical activity, diet and alcohol consumption before diagnosis (n = 678) and after completing primary treatment (n = 512). Clinical data and vital status for each woman were ascertained through medical records. Cox proportional hazards regression was conducted to calculate hazard ratios (HR) and 95% confidence interval (CI) for all‐cause mortality. There was a suggestive association between a more healthy lifestyle before diagnosis and better survival (HR 0.79, 95% CI: 0.59‐1.04), however, the association was stronger for lifestyle after diagnosis, with women in the highest tertile having significantly better survival than women in the lowest tertile (HR 0.61, 95% CI: 0.40‐0.93; P ‐trend = .02). Current smoking, particularly postdiagnosis, was associated with higher mortality (HR 1.68, 95% CI: 1.17‐2.42; HR 2.82, 95% CI: 1.29‐6.14, for prediagnosis and postdiagnosis smoking, respectively), but women who quit after diagnosis had survival outcomes similar to nonsmokers (HR 0.99, 95% CI: 0.57‐1.72). Higher physical activity after diagnosis was associated with better survival (HR 0.60, 95% CI: 0.39‐0.92; P ‐trend = .02). A healthy lifestyle after diagnosis, in particular not smoking and being physically active, may help women with ovarian cancer improve their prognosis. Abstract : What's new? The outlook for ovarian cancer patients has been steadily improving. Nonetheless, in high‐income countries, relative five‐year survival rates remain below 50 percent. This study examined the potential for modifiable lifestyle factors and healthy lifestyle to positively impact overall survival following ovarian cancer diagnosis. Analyses show that particularly after diagnosis, overall healthy lifestyle and higher physical activity were associated with improved survival. Meanwhile, smoking was linked to increased mortality, though outcome was better among women who quit smoking post‐diagnosis. The results suggest that women recently diagnosed with ovarian cancer can make lifestyle changes that impact and potentially improve their survival.