Table 3.

Hazard ratios and 95% confidence intervals for risk of lethal prostate cancer by lifestyle score in HPFS (1990–2010) and PHS (1987–2010)*

Lifestyle scores	Exposures updated over follow-up				Exposures updated until date of diagnosis
	Person-years of follow-up	No. of lethal prostate cancer cases	Age-adjusted HR (95% CI)	Multivariable-adjusted HR (95% CI)†	Person-years of follow-up	No. of lethal prostate cancer cases	Age-adjusted HR (95% CI)	Multivariable-adjusted HR (95% CI)†
Lifestyle score, HPFS‡
0–1 (less healthy) (Ref)	44 744	46	1	1	44 860	50	1	1
2	164 717	128	0.66 (0.46 to 0.92)	0.65 (0.46 to 0.92)	164 927	126	0.61 (0.43 to 0.84)	0.60 (0.43 to 0.84)
3	317 101	278	0.62 (0.45 to 0.85)	0.62 (0.45 to 0.85)	316 540	256	0.54 (0.39 to 0.73)	0.53 (0.39 to 0.73)
4	163 946	101	0.46 (0.32 to 0.65)	0.45 (0.31 to 0.64)	164 107	116	0.48 (0.34 to 0.68)	0.48 (0.34 to 0.68)
5–6 (more healthy)	52 493	23	0.32 (0.19 to 0.54)	0.32 (0.19 to 0.52)	52 567	28	0.37 (0.23 to 0.59)	0.37 (0.23 to 0.59)
P trend			<.001	<.001			<.001	<.001
Diet score, HPFS§
0 (less healthy) (Ref)	126 403	123	1	1	126 792	126	1	1
1	449 206	346	0.72 (0.59 to 0.89)	0.74 (0.60 to 0.91)	448 956	333	0.69 (0.56 to 0.85)	0.71 (0.57 to 0.87)
2	144 098	94	0.61 (0.47 to 0.81)	0.64 (0.49 to 0.84)	144 052	103	0.66 (0.51 to 0.86)	0.69 (0.53 to 0.91)
3 (more healthy)	23 293	13	0.50 (0.28 to 0.89)	0.54 (0.30 to 0.96)	23 201	14	0.54 (0.31 to 0.94)	0.58 (0.33 to 1.01)
P trend			.0002	.0007			.001	.005
Lifestyle score, PHS‡
0–1 (less healthy) (Ref)	10 362	11	1	1	10 369	11	1	1
2	57 896	48	0.71 (0.36 to 1.41)	0.76 (0.38 to 1.52)	58 191	55	0.80 (0.41 to 1.58)	0.86 (0.43 to 1.70)
3	159 279	134	0.61 (0.32 to 1.17)	0.67 (0.35 to 1.29)	159 615	134	0.61 (0.32 to 1.16)	0.66 (0.34 to 1.28)
4	121 601	104	0.53 (0.28 to 1.03)	0.57 (0.29 to 1.10)	121 238	100	0.53 (0.27 to 1.01)	0.57 (0.29 to 1.11)
5–6 (more healthy)	40 079	40	0.54 (0.27 to 1.10)	0.62 (0.30 to 1.26)	39 805	37	0.52 (0.26 to 1.06)	0.62 (0.30 to 1.27)
P trend			.05	.09			.009	.03
Diet score, PHS§
0 (less healthy) (Ref)	33 741	39	1	1	33 672	31	1	1
1	192 483	150	0.66 (0.45 to 0.97)	0.71 (0.48 to 1.05)	193 033	160	0.80 (0.53 to 1.19)	0.89 (0.59 to 1.33)
2	138 906	132	0.67 (0.45 to 0.99)	0.70 (0.47 to 1.04)	138 704	125	0.75 (0.50 to 1.13)	0.83 (0.54 to 1.24)
3 (more healthy)	24 088	16	0.63 (0.36 to 1.09)	0.70 (0.40 to 1.23)	23 808	21	0.65 (0.36 to 1.17)	0.78 (0.44 to 1.41)
P trend			.19	.25			.15	.30

* Cox proportional hazards regression with two-sided P values. We used a four- to six-year lag for all exposures to reduce the potential for reverse causation. Follow-up for the Health Professionals Follow-up Study began in 1990, using exposures ascertained in 1986. Follow-up for PHS started in 1987, using exposures ascertained starting in 1982. CI = confidence interval; HPFS = Health Professionals Follow-up Study; HR = hazard ratio; PHS = Physicians’ Health Study.

† Adjusted for age in months (continuous), race (white, non-white, missing), diabetes (yes, no, missing), multivitamin use (yes, no, missing), and vitamin E use (yes, no, missing). We used age as the time scale, stratified by calendar time in months (HPFS) and two-year intervals (PHS). Additionally adjusted for randomization status (aspirin, beta-carotene, both, or neither) in the PHS. The multivariable model for the diet score was additionally adjusted for body mass index, physical activity, and smoking status.

‡ Lifestyle score is determined by number of healthy lifestyle factors: 0 (least healthy) - 6 (more healthy).

§ Diet score is determined by number of healthy diet factors: 0 (least healthy) - 3 (more healthy).