Cancer Survival Linked to Healthy Lifestyle Choices

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In 2022, the American Cancer Society (ACS) updated its nutrition and activity guidelines for cancer survivors, recommending they avoid obesity, stay physically active, eat a healthy diet and limit alcohol intake. New research by ACS scientists shows that a lifestyle aligned with these guidelines is associated with a lower mortality risk among non-smoking survivors of obesity-related cancers in the United States. Survivors who maintained a healthy lifestyle both before and after their diagnosis — or those who improved their habits after diagnosis — also had a lower mortality risk. The study is out today in the Journal of the National Cancer Institute (JNCI).

“A cancer diagnosis often motivates people to think about how they can live healthier lives. Many survivors want to know what lifestyle changes they can make to improve their chances of living longer,” said Dr. Ying Wang, senior principal scientist, epidemiology research at the American Cancer Society and lead author of the study. “These findings underscore how making the right lifestyle choices truly affects cancer survival.”

Researchers analyzed the lifestyle habits of non-smoking participants from the Cancer Prevention Study-II Nutrition Cohort diagnosed with obesity-related cancers between 1992 and 2002 through 2020. Post-diagnosis adherence to ACS guidelines—body mass index (BMI), physical activity, diet, and alcohol consumption—was scored on a scale from 0 to 8. Models were used to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).

Study results showed that among 3,742 cancer survivors (average age 67.6 years) with a median follow-up of 15.6 years, 2,430 deaths occurred. Survivors with a score of 6-8 had a 24% lower risk of all-cause mortality (HR = 0.76; 95% CI = 0.68 to 0.85), a 33% lower risk of cardiovascular disease mortality (HR = 0.67; 95% CI = 0.54 to 0.83), and a 21% lower risk of cancer-specific mortality (HR = 0.79; 95% CI = 0.64 to 0.97) compared to those with a score of 0-3. Higher BMI and physical activity scores were associated with lower all-cause mortality. Compared to survivors with a consistently low ACS guideline score (less than 5) both before and after diagnosis, those with a consistently high score (five or more) had lower all-cause and cardiovascular disease mortality. Additionally, survivors who improved their score from low to high had lower all-cause mortality.

Other ACS researchers contributing to this study include Christina Newton, Dr. Marjorie McCullough, Dr. Lauren Teras, Dr. Clara Bodelon, Dr. Erika Rees-Punia, Dr. Caroline Um, Dr. Laura Makaroff, and senior author Dr. Alpa Patel.

Reference: Wang Y, Newton CC, McCullough ML, et al. Following the American Cancer Society guideline for cancer survivors and obesity-related cancer survival. JNCI. 2025. doi:  10.1093/jnci/djaf051

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