title: The role of lifestyle characteristics on prostate cancer progression in two active surveillance cohorts.
abstract: Although much research has examined the relationship between lifestyle and prostate cancer (PCa) risk, few studies focus on the relationship between lifestyle and PCa progression. The present study examines this relationship among men initially diagnosed with low- to intermediate-risk PCa and managed with active surveillance (AS).
  
  
  
  Men enrolled in two separate AS programs were recruited for this study. Data regarding clinical, demographic and lifestyle characteristics were collected. Results were then compared between men whose disease remained low- to intermediate-risk and men whose disease progressed.
  
  
  
  Demographic, clinical and physical characteristics were similar between comparative groups and cohorts, with the exception that age at the time of diagnosis and questionnaire was increased among men whose disease progressed. Lifestyle scores among men who remained low- to intermediate-risk were higher than those whose risk progressed; however, scores were only significant in one cohort on univariable analysis. On multivariable analysis, the only predictor of progression was age at diagnosis. Physical activity was consistently higher in both low risk groups, although this difference was insignificant. Consistent differences in other lifestyle variables were not observed.
  
  
  
  Age remains an important predictor of PCa progression. Improving lifestyle characteristics among men initially managed with AS might help to reduce the risk of progression. Given the limitations of this study, more rigorous investigation is required to confirm whether lifestyle characteristics influence the progression of low- to intermediate-risk PCa.
authors.affiliation: Division of Urology, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: A D
authors.initials: AD
authors.lastname: Vandersluis
authors.affiliation: Division of Urology, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: D E
authors.initials: DE
authors.lastname: Guy
authors.affiliation: Division of Urology, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: L H
authors.initials: LH
authors.lastname: Klotz
authors.affiliation: Division of Urology, Department of Surgery, Princess Margaret Hospital, Toronto, ON, Canada.
authors.forename: N E
authors.initials: NE
authors.lastname: Fleshner
authors.affiliation: Evaluative Clinical Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Kiss
authors.affiliation: Institute of Cancer Research, Royal Marsden Hospital, Sutton, Surrey, UK.
authors.forename: C
authors.initials: C
authors.lastname: Parker
authors.affiliation: Division of Urology, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: V
authors.initials: V
authors.lastname: Venkateswaran
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018450:Disease Progression; D005247:Feeding Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D016017:Odds Ratio; D011159:Population Surveillance; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors