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@ARTICLE{Zhu:294812,
      author       = {C. Zhu$^*$ and Z. Lian$^*$ and V. Arndt$^*$ and M.
                      Thong$^*$},
      title        = {{C}ombined lifestyle factors on mortality and
                      cardiovascular disease among cancer survivors: a systematic
                      review and meta-analysis of cohort studies.},
      journal      = {Supportive care in cancer},
      volume       = {32},
      number       = {12},
      issn         = {0941-4355},
      address      = {New York,NY},
      publisher    = {Springer},
      reportid     = {DKFZ-2024-02524},
      pages        = {846},
      year         = {2024},
      note         = {#EA:C071#LA:C071#},
      abstract     = {Lifestyle factors in cancer survivors are frequently
                      studied individually even though they are often
                      interconnected. This systematic review and meta-analysis
                      investigated the association of combined lifestyle factors
                      on health outcomes among cancer survivors.EMBASE, PubMed and
                      Web of Science were searched up to March 2024. Cohort
                      studies examining the associations of at least three
                      combined lifestyle factors with mortality
                      (all-cause/cancer-specific) and cardiovascular disease (CVD)
                      among cancer survivors, were selected. Pooled hazard ratios
                      (pHRs) and $95\%$ confidence intervals (CIs) were estimated
                      using random effects models. Tests for heterogeneity and
                      publication bias were conducted.Twenty-two studies involving
                      209,659 survivors with an average follow-up duration ranging
                      from 4.1 to 29.1 years were included. $pHRs(95\%CI)$
                      comparing cancer survivors with the healthiest lifestyles
                      versus those with the least healthy lifestyles were 0.57
                      (0.51-0.65) for all-cause mortality, 0.70 (0.61-0.80) for
                      cancer-specific mortality, and 0.53 (0.46-0.63) for CVD
                      incidence. These associations were largely consistent across
                      subgroup analyses. Colorectal cancer survivors with the
                      healthiest lifestyle experienced $37\%$ lower all-cause
                      mortality and $25\%$ lower cancer-specific mortality, while
                      breast cancer survivors had a $45\%$ reduction in all-cause
                      mortality. Although studies were limited, significant
                      associations for all-cause mortality were observed among
                      lung, liver, nasopharyngeal, gastric, kidney, gynecologic
                      cancer survivors. However, no significant relationship
                      between healthy lifestyles and CVD-specific mortality was
                      detected.Having an overall healthy lifestyle is associated
                      with lower CVD incidence and better survival among cancer
                      survivors. The long-term management of cancer survivors
                      should consider encouragement for a modification of multiple
                      lifestyles.},
      subtyp        = {Review Article},
      keywords     = {Humans / Cancer Survivors: statistics $\&$ numerical data /
                      Cardiovascular Diseases: mortality / Cardiovascular
                      Diseases: etiology / Cardiovascular Diseases: epidemiology /
                      Life Style / Neoplasms: mortality / Cohort Studies / Risk
                      Factors / Cancer survivor (Other) / Cardiovascular disease
                      (Other) / Lifestyle (Other) / Meta-analysis (Other) /
                      Mortality (Other) / Systematic review (Other)},
      cin          = {C071},
      ddc          = {610},
      cid          = {I:(DE-He78)C071-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39623080},
      pmc          = {pmc:PMC11611996},
      doi          = {10.1007/s00520-024-09049-2},
      url          = {https://inrepo02.dkfz.de/record/294812},
}