Evidence mapPaperPMID 41004150Full record

ArticleJAMA network open2025

Adherence to American Cancer Society Guideline and Mortality in Men With Nonmetastatic Prostate Cancer.

Valeria Elahy, Christina C Newton, Marjorie L McCullough, Lauren R Teras, Clara Bodelon, Erika Rees-Punia, Caroline Y Um, Laura Makaroff, Alpa V Patel, Ying Wang

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Valeria ElahyDepartment of Population Science, American Cancer Society, Atlanta, Georgia.
Christina C NewtonDepartment of Population Science, American Cancer Society, Atlanta, Georgia.
Marjorie L McCulloughDepartment of Population Science, American Cancer Society, Atlanta, Georgia.
Lauren R TerasDepartment of Population Science, American Cancer Society, Atlanta, Georgia.
Clara BodelonDepartment of Population Science, American Cancer Society, Atlanta, Georgia.
Erika Rees-PuniaDepartment of Population Science, American Cancer Society, Atlanta, Georgia.
Caroline Y UmDepartment of Population Science, American Cancer Society, Atlanta, Georgia.
Laura MakaroffDepartment of Cancer Prevention and Survivorship, American Cancer Society, Atlanta, Georgia.
Alpa V PatelDepartment of Population Science, American Cancer Society, Atlanta, Georgia.
Ying WangDepartment of Population Science, American Cancer Society, Atlanta, Georgia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Among men with nonmetastatic prostate cancer, prostate cancer-specific mortality (PCSM) is the leading cancer-related cause of death, and cardiovascular disease mortality (CVDM) is the most common non-cancer-related cause. The American Cancer Society (ACS) guideline for cancer survivors recommends avoiding obesity, engaging in regular physical activity, and following a healthy diet. While physical activity and body weight have been associated individually with lower mortality in patients with prostate cancer, the combined effect of all ACS guideline components remains unclear. Objective: To examine the association between postdiagnosis ACS guideline concordance and mortality in nonmetastatic prostate cancer survivors. Design, Setting, and Participants: This cohort study used data from the Cancer Prevention Study-II Nutrition Cohort and included men diagnosed with nonmetastatic prostate cancer between 1992 and 2003 and followed up from postdiagnosis survey completion until death or December 31, 2020. Analyses were conducted from March 2024 to February 2025. Exposure: Prediagnosis and postdiagnosis ACS guideline concordance was scored from 0 to 8, with higher scores indicating greater adherence. Main Outcomes and Measures: Mortality outcomes, including all-cause mortality (ACM), CVDM, and PCSM, were ascertained via National Death Index linkage. Cox proportional hazards regressions were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% CIs across score categories (categorized as 0-3, 4, 5, and 6-8). Results: Among 4232 prostate cancer survivors (median [IQR] age at diagnosis, 69 [65.0-73.0] years) followed for a median (IQR) of 14.1 (8.4-17.5) years, there were 3101 ACM outcomes (73.3%), 912 CVDM outcomes (21.6%), and 453 PCSM outcomes (10.7%). Higher postdiagnosis ACS score (ie, 6 to 8 vs 0 to 3) was associated with lower risk of ACM (HR, 0.77; 95% CI, 0.69-0.85; per 1-point increase: HR, 0.94; 95% CI, 0.91-0.96; P < .001) and CVDM (HR, 0.75; 95% CI, 0.63-0.91; per 1-point increase: HR, 0.93; 95% CI, 0.89-0.97; P = .001), while results for PCSM were not statistically significant. Results were similar when stratified by tumor aggressiveness. Patients who improved their guideline concordance after diagnosis (ie, a score of <5 to ≥5) or maintained high concordance (ie, a score of ≥5 to ≥5) had lower mortality risk compared with those who maintained low scores. Conclusions and Relevance: In this cohort study of men with nonmetastatic prostate cancer, higher postdiagnosis ACS guideline concordance and improvements in concordance were associated with lower ACM and CVDM, highlighting the importance of lifestyle modifications in prostate cancer survivorship.

Indexed as

Cancer SurvivorsGuideline AdherenceProstatic NeoplasmsAgedAmerican Cancer SocietyCohort StudiesExerciseHumansMaleMiddle AgedPractice Guidelines as TopicUnited States

Identifiers

PMID41004150
PMCPMC12475947

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.