Table 1.
Factors with evidence beneficial associations with NMIBC outcomes
| Factor | Evidence summary |
|---|---|
| Healthy BMI*** | Multiple studies have reported elevated BMI (≥25 kg/m2) is associated with increased risks of recurrence and progression, with more ambiguous results suggesting increased risks of CSM and ACM. Two studies reported that sarcopenia may be a better body composition metric for predicting outcomes than BMI. |
| Lactobacillus casei supplementation*** | Three RCTs reported supplementation reduces risk of recurrence. |
| Smoking avoidance/cessation*** | Multiple studies have reported that current smoking is associated with recurrence. Current and former smoking may be associated with CSM. Long-term smoking cessation may be associated with reduced recurrence and progression. |
| DMII prevention and treatment** | Associations are ambiguous; however, a few studies have reported associations with improved outcomes among patients with DMII treated with metformin. |
| Broccoli (uncooked)** | One study reported higher intake was associated with reduced CSM and ACM. |
| Supplemental vitamin B9 (folate) avoidance** | One study reported supplementation was associated with an increased risk of recurrence. |
| Supplemental vitamin E** | One study reported supplementation was associated with a reduced risk of recurrence. |
| “Western diet” avoidance** | One study reported a diet high in red meat and fried foods was associated with an increased risk of recurrence. |
| Areca nut chewing avoidance* | One study reported that heavy use (>10 nuts/day) was associated with increased risk of recurrence. |
| Glyburide avoidance* | One study reported use was associated with increased risk of CSM. |
ACM= All-cause mortality, BMI = Body mass index, CSM = Cancer-specific mortality, DMII = Diabetes Mellitus type II, NMIBC = Nonmuscle invasive bladder cancer, RCT = Randomized controlled trial.
*
Evidence from retrospective studies suggests benefit.
**
Evidence from prospective studies or non-randomized trial suggests benefit.
***
Evidence from meta-analyses and/or randomized controlled trials suggests benefit.