本研究旨在探讨糖尿病风险降低饮食（DRRD）与前列腺、肺部、结直肠、卵巢（PLCO）队列中膀胱癌风险的关系。使用Cox比例风险回归模型对前列腺、肺部、结直肠和卵巢（PLCO）癌症筛查试验中的99,001名参与者的数据进行分析，以估计DRRD评分与膀胱癌发病率之间的关联的风险比（HR）和95％置信区间（CI）。进行亚组分析以评估年龄、性别、BMI、吸烟状态和糖尿病史等变量是否影响所观察到的关联。DRRD评分是基于从膳食史问卷中提取的九个营养摄入指标制定的。在中位随访11.7年的期间，鉴定出761例新的膀胱癌病例。最高的DRRD评分的参与者与最低四分位数的参与者相比，膀胱癌的风险降低（未经调整的分析，风险比[HR] = 0.65 [95％CI 0.53至0.82]；多变量调整分析，HR = 0.79 [95％CI 0.64至0.98]，P趋势= 0.007）。仅在移行细胞癌中观察到类似的风险降低（HR = 0.79 [95％CI 0.64至0.99]，P = 0.007）。此外，在排除具有独特特征的参与者后，DRRD评分与膀胱癌风险之间的显著负相关仍然存在。这项大型前瞻性基于人群的研究表明，坚持DRRD可能有助于预防膀胱癌。DRRD有可能减轻膀胱癌风险，需要在不同人群中进一步验证。

This study aimed to explore the relationship between Diabetes Risk Reduction Diet (DRRD) and bladder cancer risk in Prostate, Lung, Colorectal, Ovarian (PLCO) cohort.Data from 99,001 participants in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial were analyzed using Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between DRRD score and bladder cancer incidence. Subgroup analyses were conducted to assess whether variables such as age, sex, BMI, cigarette smoking status, and history of diabetes influenced the observed association. The DRRD score was formulated based on nine nutrient intake indicators derived from the Dietary History Questionnaire.During the median follow-up of 11.7 years, 761 new bladder cancer cases were identified. Participants with highest DRRD scores exhibited a reduced risk of bladder cancer compared to those in the lowest quartile (unadjusted analysis, hazard ratio [HR] = 0.65 [95% CI 0.53 to 0.82]; multivariable adjusted analysis, HR = 0.79 [95% CI 0.64 to 0.98], P-trend = 0.007). A similar risk reduction was seen solely in transitional cell carcinoma (HR = 0.79 [95% CI 0.64 to 0.99], P = 0.007). Additionally, the significant negative association between DRRD scores and bladder cancer risk persisted even after excluding participants with unique characteristics.This large prospective population-based study suggests that adherence to a DRRD may contribute to the prevention of bladder cancer.The DRRD could potentially mitigate bladder cancer risk, which warrants further validation in diverse populations.