title: Lifestyle factors and health-related quality of life in bladder cancer survivors: a systematic review.
abstract: Diet, physical activity, and smoking cessation are modifiable lifestyle factors that have been shown to improve health-related quality of life (HRQOL) in many cancer survivors. Our objective was to systematically review the literature on the associations between lifestyle factors, namely diet, physical activity, smoking status, and HRQOL in bladder cancer survivors.
  
  
  
  We queried PubMed, EMBASE, and Cochrane libraries. Two reviewers reviewed abstracts independently, and a third reviewer arbitrated disagreements. A descriptive analysis was performed. Quality assessment was conducted using the Newcastle-Ottawa Quality Assessment Scale for observational studies and the Cochrane Risk of Bias Tool for clinical trials.
  
  
  
  We identified 1167 publications in the initial search, of which 9 met inclusion criteria for full-text review. We were able to obtain data on the outcomes of interest for 5 publications. A total of 1288 patients who underwent treatment for bladder cancer were included. Three studies were observational by design and two were randomized controlled trials. Physical activity was addressed by 4 studies, smoking status by 2 studies, and diet by 1 study.
  
  
  
  The review highlights the limited evidence around lifestyle factors and quality of life in bladder cancer survivors. There is some evidence for a positive association between HRQOL and physical activity, but insufficient evidence upon which to draw conclusions about the effects of consuming fruits and vegetables or non-smoking.
  
  
  
  There is limited evidence to support a positive association between health-related quality of life and physical activity, but insufficient evidence upon which to base any conclusions about consumption of fruits and vegetables or smoking cessation in bladder cancer survivors.
authors.affiliation: Division of Urology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, 27710, USA.
authors.forename: Ajay
authors.initials: A
authors.lastname: Gopalakrishna
authors.affiliation: Division of Urology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, 27710, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Longo
authors.affiliation: Division of Urology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, 27710, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Fantony
authors.affiliation: Research and Education Services, Duke University Medical Center, 2301 Erwin Road, Durham, NC, 27710, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Van Noord
authors.affiliation: Division of Urology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, 27710, USA. Brant.Inman@duke.edu.|, Box 103868, 3007 Snyderman Bldg 905 La Salle Street, Durham, NC, 27710, USA. Brant.Inman@duke.edu.
authors.forename: Brant A
authors.initials: BA
authors.lastname: Inman
mesh_terms: D006304:Health Status; D006801:Humans; D008019:Life Style; D011788:Quality of Life; D017741:Survivors / Q000523:psychology*; D001749:Urinary Bladder Neoplasms / Q000523:psychology* / Q000628:therapy
keywords: Bladder cancer; Diet; Exercise; Lifestyle factors; Quality of life; Smoking; Urothelial carcinoma