Association of Life's Essential 8 metrics with mortality outcomes in US cancer survivors

Abstract Aims The increased in global cancer survivors and treatment complications has created an unmet need for effective long-term health strategies. This study aimed to evaluate the relationship between LE8 and all-cause, cancer-specific, and non-cancer mortality in cancer survivors in the US. Methods A prospective cohort study was conducted using a nationally representative sample of cancer survivors, age 40 years or older (n = 2205), derived from the US. Cancer diagnoses were determined through face-to-face interviews, while health status was gauged using the LE8 score on a scale of 0-100. Multivariable Cox proportional hazards regression models were applied to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the associations of overall and individual component of LE8 with overall, cancer-specific, and noncancer mortality, respectively. Result Among the 2205 participants (mean [SE] age, 66.4 [0.4] years; 54.1% females; 87.4% non-Hispanic White ethnicity), the average LE8 score was 65.5 ± 0.4, with diet having the lowest (45.5 ± 1.0) and the highest scores attributed to sleep (85.1 ± 0.7). During the up to 5.7 years follow-up period, 526 deaths were documented, comprising 174 cancer-related, 123 cardiovascular disease-related, and 229 from other causes. A high LE8 score was linked to a 71% reduction in all-cause mortality risk (HR: 0.29, 95% CI: 0.16-0.54) as well as significant reduction in the risk of cancer deaths (HR: 0.34, 95% CI: 0.13-0.88) and non-cancer deaths (HR: 0.26, 95% CI: 0.13-0.52). Higher LE8 scores were still correlated with reduced mortality in cancer survivors without cardiovascular conditions, while adherence to certain health behaviors was tied to a lower death risk. Conclusions In this study, high LE8 scores, especially the health behaviors component, were strongly associated with extended life expectancy and lower mortality rates.