Diet, Physical Activity, and Smoking in Patients Living with Non-Muscle Invasive Bladder Cancer

Background Modifiable lifestyle factors have been implicated in bladder cancer outcomes. Further study is warranted to inform future strategies in patients with non-muscle invasive bladder cancer (NMIBC). Objective We aim to describe modifiable behaviors (smoking, diet, and physical activity) in a cohort of patients with NMIBC. Methods We conducted an observational cross-sectional study in patients undergoing surveillance for NMIBC. A comprehensive survey comprised of validated measures of physical activity, diet, and mutagen consumption was administered. We assessed a “healthy lifestyle score” consisting of body mass index (BMI) <25, smoking status, and physical activity (aerobic exercise minutes). We examined differences in lifestyle factors by stage, grade, recurrence, BMI, age, gender, and education level. Results In a cohort of 113 NMIBC patients, median age was 67 years (IQR: 59, 73) and median time since initial diagnosis was 26 months (IQR: 9, 42). Low levels of healthy habits are common among patients with NMIBC. Those with a BMI of ≥25 has greater red and processed meat intake, higher mutagen intake, and lower physical activity. Older patients reported more supplement use and lower physical activity. Low education level was associated with a less healthy lifestyle (higher processed meat consumption, higher Meiqx mutagen consumption, and lower physical activity). Conclusions In patients undergoing surveillance for NMIBC, 25% had all three components reflecting a healthy lifestyle. Older age, lower education, and higher body mass index were associated with fewer healthy habits. Education on healthy lifestyle changes should be a key component in NMIBC survivorship care.