Diet Quality and Survival in a Population-Based Bladder Cancer Study

Abstract

Nutrition may impact bladder cancer survival. We examined the association between diet quality and overall and bladder cancer-specific survival. Bladder cancer cases from a population-based study reported pre-diagnosis diet. Diet quality was assessed using the 2010 Alternate Healthy Eating Index (AHEI-2010). Vital status was ascertained from the National Death Index. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated using proportional hazards and competing risks regression models. Overall AHEI-2010 adherence was not associated with overall or bladder cancer-specific survival among non-muscle invasive bladder cancer (NMIBC) cases (HR, 1.00; 95% CI, 0.98-1.01; HR, 1.00; 95% CI, 0.97-1.02) or muscle invasive bladder cancer (MIBC) cases (HR, 0.99; 95% CI, 0.96-1.03; HR, 1.01, 95% CI 0.97-1.06). AHEI-2010 sugar-sweetened beverages adherence was associated with poorer overall survival (HR, 1.04; 95% CI, 1.01-1.08) and AHEI-2010 sodium adherence was associated with better overall and bladder cancer-specific survival after NMIBC diagnosis (HR, 0.92, 95% CI, 0.85-1.00; HR, 0.82; 95% CI, 0.68-0.98). AHEI-2010 fruit adherence was associated with poorer overall and bladder cancer-specific survival after MIBC diagnosis (HR, 1.17; 95% CI, 1.02-1.33; HR, 1.26; 95% CI, 1.03-1.55). Consumption of sugar-sweetened beverages, sodium, and fruit, not overall AHEI-2010 adherence, may be associated with bladder cancer survival.

Acknowledgments

The authors would like to thank the staff, physicians, pathology lab personnel, and the participants of the New Hampshire bladder cancer study. The authors acknowledge the contribution of the New Hampshire State Cancer Registry, New Hampshire Department of Health and Human Services, as well as the National Death Index administered by the National Center for Health Statistics.

Disclosure of Interest

The authors report no conflicts of interest.

Author Contributions

R.C.L., M.R.K., D.G.D., J.A.E., and M.N.P. designed the research; R.C.L. conducted the research and performed statistical analysis; R.C.L., M.R.K., D.G.D., and M.N.P. analyzed the data; R.C.L. and M.N.P. wrote the paper. For the original case-control study, M.R.K. and M.S.Z. collected data; A.R.S. performed the uniform histopathology review; and A.D.S. classified bladder cancer treatment. M.N.P. had primary responsibility for final content. All authors have read and approved the final manuscript.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author, M.N.P., upon reasonable request.

Additional information

Funding

This work was supported by the National Institute of Environmental Health Sciences, National Institutes of Health (NIH) under Grant P42ES007373, the National Cancer Institute (NCI), NIH under Grant R01CA57494, and the Intramural Research Program of the NIH, NCI, Division of Cancer Epidemiology and Genetics under Contract N02-CP-01037.