众所周知，可改变的生活方式因素会影响生存。目前尚不清楚曾经诊断出患有乳腺癌的绝经后女性和未受影响的女性之间是否存在差异。从 2002 年至 2005 年招募了诊断患有乳腺癌的女性和年龄相当的未受影响的女性，并随访至 2020 年。使用基线信息，生活方式依从性评分（范围0-8；分为低[0-3.74]、中[3.75-4.74]和高[≥4.75]）是根据2018年世界癌症研究基金会/美国癌症研究所（WCRF/AICR）创建的癌症预防建议。使用 Cox 回归和竞争风险分析来分析遵守 WCRF/AICR 生活方式建议分别与总体死亡率以及心血管疾病和癌症导致的死亡之间的关系。 总共纳入了 8584 名女性（其中 2785 名患有乳腺癌，5799 名未患有乳腺癌） ）。中位随访时间为 16.1 年，死亡总数为 2006 年。在已知原因的死亡中（98.6%），445 例与心血管相关，1004 例与癌症相关。平均生活方式得分为 4.2。病例对照状态的生活方式评分对死亡率没有差异影响。调整协变量后，中度（风险比 [HR]，0.66；95% 置信区间 [CI]，0.57-0.76）和高度（HR，0.54；95% CI，0.47-0.63）遵守 WCRF/AICR 生活方式建议的情况如下：与总死亡率的下降显着相关。同样，在竞争风险分析中，中度和高度依从性与心血管疾病和癌症死亡率降低相关。健康的生活方式可以大大降低女性的死亡风险。由于大约三分之一的研究参与者对所有 WCRF/AICR 指南的遵守率较低，因此有必要采取健康干预措施。© 2023 作者。 《癌症》由 Wiley periodicals LLC 代表美国癌症协会出版。

Modifiable lifestyle factors are known to impact survival. It is less clear whether this differs between postmenopausal women ever diagnosed with breast cancer and unaffected women.Women diagnosed with breast cancer and unaffected women of comparable age were recruited from 2002 to 2005 and followed up until 2020. Using baseline information, a lifestyle adherence score (range 0-8; categorized as low [0-3.74], moderate [3.75-4.74], and high [≥4.75]) was created based on the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations. Cox regression and competing risks analysis were used to analyze the association of adherence to WCRF/AICR lifestyle recommendations with overall mortality and with death due to cardiovascular diseases and cancer, respectively.A total of 8584 women were included (2785 with breast cancer and 5799 without). With a median follow-up of 16.1 years there were 2006 total deaths. Among the deaths of known causes (98.6%), 445 were cardiovascular-related and 1004 were cancer-related. The average lifestyle score was 4.2. There was no differential effect of lifestyle score by case-control status on mortality. After adjusting for covariates, moderate (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.57-0.76) and high (HR, 0.54; 95% CI, 0.47-0.63) adherence to WCRF/AICR lifestyle recommendations were significantly associated with a decrease in overall mortality. Similarly, in competing risks analysis, moderate and high adherence were associated with decreased mortality from cardiovascular diseases and from cancer.A healthy lifestyle can substantially reduce mortality risk in women. With low adherence to all WCRF/AICR guidelines in about a third of study participants, health interventions are warranted.© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.