scholarly journals Impact of Immigration Status on Cancer Outcomes in Ontario, Canada

2017 ◽  
Vol 13 (7) ◽  
pp. e602-e612 ◽  
Author(s):  
Matthew C. Cheung ◽  
Craig C. Earle ◽  
Hadas D. Fischer ◽  
Ximena Camacho ◽  
Ning Liu ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Hematologic Malignancies ◽  
Cox Proportional Hazards ◽  
Administrative Databases ◽  
Healthy Immigrant Effect ◽  
Recent Immigrants ◽  
Explanatory Variables ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
The Impact

Background: Prior studies have documented inferior health outcomes in vulnerable populations, including racial minorities and those with disadvantaged socioeconomic status. The impact of immigration on cancer-related outcomes is less clear. Methods: Administrative databases were linked to create a cohort of incident cancer cases (colorectal, lung, prostate, head and neck, breast, and hematologic malignancies) from 2000 to 2012 in Ontario, Canada. Cancer patients who immigrated to Canada (from 1985 onward) were compared with those who were Canadian born (or immigrated before 1985). Patients were followed from diagnosis until death (cancer-specific or all-cause). Cox proportional hazards models were estimated to determine the impact of immigration on mortality after adjusting for explanatory variables. Additional adjusted models studied the relationship of time since immigration and cancer-specific and overall mortality. Results: From 2000 to 2012, 11,485 cancer cases were diagnosed in recent immigrants (0 to 10 years in Canada), 17,844 cases in nonrecent immigrants (11 to 25 years), and 416,118 cases in nonimmigrants. After adjustment, the hazard of mortality was lower for recent immigrants (hazard ratio [HR], 0.843; 95% CI, 0.814 to 0.873) and nonrecent immigrants (HR, 0.902; 95% CI, 0.876 to 0.928) compared with nonimmigrants. Cancer-specific mortality was also lower for recent immigrants (HR, 0.857; 95% CI, 0.823 to 0.893) and nonrecent immigrants (HR, 0.907; 95% CI, 0.875 to 0.94). Among immigrants, each year from the original landing was associated with increased mortality (HR, 1.004; 95% CI, 1.000 to 1.009) and a trend to increased cancer-specific mortality (HR, 1.005; 95% CI, 0.999 to 1.010). Conclusion: Immigrants demonstrate a healthy immigrant effect, with lower cancer-specific mortality compared with Canadian-born individuals. This benefit seems to diminish over time, as the survival of immigrants from common cancers potentially converges with the Canadian norm.

The impact of immigration status on cancer outcomes in Ontario, Canada.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 285-285
Author(s):  
Matthew C. Cheung ◽  
Craig Earle ◽  
Hadas Fischer ◽  
Ximena Camacho ◽  
Refik Saskin ◽  
...  
Keyword(s):  
Cox Regression ◽  
Administrative Databases ◽  
Immigration Status ◽  
Healthy Immigrant Effect ◽  
Cancer Specific Survival ◽  
Recent Immigrants ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Incident Cases ◽  
The Impact

285 Background: In the delivery of cancer care, barriers to access could potentially result in inferior outcomes and survival. Although a relationship has been demonstrated between disadvantaged socio-economic status and mortality, the impact of immigration on outcomes is less clear. Methods: Administrative databases were linked to create a cohort of all incident cases of colorectal, lung, prostate, head/neck, breast and hematologic malignancies from Jan 2000 to Dec 2012 in Ontario, Canada. Cases were defined according to immigration status and followed from diagnosis until death (or cancer-specific death). Cox proportional hazards models were constructed to study the impact of immigration status on survival after adjusting for relevant variables. Additional adjusted models studied the relationship of time since immigration on mortality. Results: During the study period, 11,485 cancer cases were diagnosed in recent immigrants (0-10 years in Canada), 17,844 cases in non-recent immigrants (11-25 years), and 416,118 cases in non-immigrants. Following adjustment for relevant predictors by Cox regression, survival was improved for recent immigrants (HR 0.843; 95% CI 0.814-0.873) and non-recent immigrants (HR 0.902; 95% CI 0.876-0.928) compared to non-immigrants. Cancer-specific survival was also better for recent immigrants (HR 0.857; 95% CI 0.823-0.893) and non-recent immigrants (HR 0.907; 95% CI 0.875-0.94) compared to non-immigrants. Amongst immigrants, each year from the original landing in Canada was associated with increased mortality (HR 1.004; 1.000-1.009) and a trend to increased cancer-specific mortality (HR 1.005; 0.999-1.010) that was not statistically significant. Immigrants from all WHO world regions were found to have similar reductions in mortality and cancer-specific mortality. Conclusions: Immigrants to Canada demonstrate a “healthy immigrant” effect, with lower mortality compared to Canadian-born individuals. This benefit appears to diminish over time, as the health of immigrants potentially converges with the Canadian norm. Potential contributors to the benefit include self-selection for immigration, health requirements for entrance, and differences in disease distribution related to ethnicity.

scholarly journals Prediagnosis plasma concentrations of enterolactone and survival after colorectal cancer: the Danish Diet, Cancer and Health cohort

2018 ◽  
Vol 122 (5) ◽  
pp. 552-563 ◽  
Author(s):  
Cecilie Kyrø ◽  
Kirsten Frederiksen ◽  
Marianne Holm ◽  
Natalja P. Nørskov ◽  
Knud E. B. Knudsen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Plasma Concentrations ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Limited Attention ◽  
Hazards Model ◽  
Specific Mortality ◽  
Cancer Specific Mortality

AbstractThe association between lifestyle and survival after colorectal cancer has received limited attention. The female sex hormone, oestrogen, has been associated with lower colorectal cancer risk and mortality after colorectal cancer. Phyto-oestrogens are plant compounds with structure similar to oestrogen, and the main sources in Western populations are plant lignans. We investigated the association between the main lignan metabolite, enterolactone and survival after colorectal cancer among participants in the Danish Diet, Cancer and Health cohort. Prediagnosis plasma samples and lifestyle data, and clinical data from time of diagnosis from 416 women and 537 men diagnosed with colorectal cancer were used. Enterolactone was measured in plasma using a liquid chromatography–tandem mass spectrometry (LC–MS/MS) method. Participants were followed from date of diagnosis until death or end of follow-up. During this time, 210 women and 325 men died (170 women and 215 men died due to colorectal cancer). The Cox proportional hazards model was used to estimate hazard ratios (HR) and 95 % CI. Enterolactone concentrations were associated with lower colorectal cancer-specific mortality among women (HRper doubling: 0·88, 95 % CI 0·80, 0·97, P=0·0123). For men, on the contrary, enterolactone concentrations were associated with higher colorectal cancer-specific mortality (HRper doubling: 1·10, 95 % CI 1·01, 1·21, P=0·0379). The use of antibiotics affects enterolactone production, and the associations between higher enterolactone and lower colorectal cancer-specific mortality were more pronounced among women who did not use antibiotics (analysis on a subset). Our results suggest that enterolactone is associated with lower risk of mortality among women, but the opposite association was found among men.

scholarly journals Association between prediagnosis depression and mortality among postmenopausal women with colorectal cancer

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244728
Author(s):  
Xiaoyun Liang ◽  
Michael Hendryx ◽  
Lihong Qi ◽  
Dorothy Lane ◽  
Juhua Luo
Keyword(s):  
Colorectal Cancer ◽  
Depressive Symptoms ◽  
Cancer Diagnosis ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Antidepressant Use

Background There are no epidemiologic data on the relation of depression before colorectal cancer diagnosis to colorectal cancer mortality among women with colorectal cancer, especially those who are postmenopausal. Our aim was to fill this research gap. Methods We analyzed data from a large prospective cohort in the US, the Women’s Health Initiative (WHI). The study included 2,396 women with incident colorectal cancer, assessed for depressive symptoms and antidepressant use before cancer diagnosis at baseline (screening visit in the WHI study) during 1993–1998. Participants were followed up from cancer diagnosis till 2018. We used Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) between depression (depressive symptoms or antidepressant use) at baseline, and all-cause mortality and colorectal cancer-specific mortality. Results Among women with colorectal cancer, there was no association between baseline depression and all-cause mortality or colorectal cancer-specific mortality after adjusting for age or multiple covariates. Conclusion Among women with colorectal cancer, there was no statistically significant association between depression before colorectal cancer diagnosis and all-cause mortality or colorectal cancer-specific mortality. Further studies are warranted to assess depressive symptoms and antidepressant use, measured at multiple points from baseline to diagnosis, and their interactions with specific types of colorectal cancer treatment on the risk of death from colorectal cancer.

Association of sleep duration with all-cause and disease-specific mortality in US adults

2021 ◽  
pp. jech-2020-215314
Author(s):  
Lili Yang ◽  
Bo Xi ◽  
Min Zhao ◽  
Costan G Magnussen
Keyword(s):  
Cardiovascular Disease ◽  
Sleep Duration ◽  
Proportional Hazards ◽  
Large Population ◽  
Cox Proportional Hazards ◽  
Increased Risk ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Cancer Specific Mortality ◽  
Disease Specific

BackgroundPrevious studies revealed inconsistent findings regarding the association between sleep duration and all-cause and disease-specific mortality. This study aimed to clarify the association of sleep duration with mortality using a large population-based prospective cohort study from the USA.MethodsWe used data from the National Health Interview Survey (2004–2014) linked to National Death Index records to 31 December 2015. A total of 284 754 participants aged ≥18 years were included. Self-reported sleep duration (average time slept in a 24-hour period) was categorised into seven groups: ≤4 hours, 5 hours, 6 hours, 7 hours (reference), 8 hours, 9 hours and ≥10 hours. Study outcomes included all-cause, cardiovascular disease-specific and cancer-specific mortality. Cox proportional hazards models were used to examine the association between sleep duration and mortality.ResultsDuring a median follow-up of 5.25 years, we identified 20 872 deaths, of which 4 129 were cardiovascular disease-related and 5 217 were cancer-related. Compared with 7 hours/day of sleep, both short and long sleep durations were associated with an increased risk of all-cause mortality (≤4 hours: HR=1.46, 95% CI=1.33–1.61; 5 hours: HR=1.22, 95% CI=1.13–1.32; 6 hours: HR=1.10, 95% CI=1.05–1.17; 8 hours: HR=1.22, 95% CI=1.17–1.28; 9 hours: HR=1.41, 95% CI=1.31–1.51; ≥10 hours: HR=2.00, 95% CI=1.88–2.13). Similar results were observed for cardiovascular disease-specific and cancer-specific mortality.ConclusionsOur study indicates that both short (≤6 hours/day) and long (≥8 hours/day) sleep durations increase the risk of mortality compared with sleep of 7 hours/day. A normal sleep duration (about 7 hours) every day is recommended for health benefits.

Active Smoking and Mortality Among Colorectal Cancer Survivors: The Cancer Prevention Study II Nutrition Cohort

2015 ◽  
Vol 33 (8) ◽  
pp. 885-893 ◽  
Author(s):  
Baiyu Yang ◽  
Eric J. Jacobs ◽  
Susan M. Gapstur ◽  
Victoria Stevens ◽  
Peter T. Campbell
Keyword(s):  
Colorectal Cancer ◽  
Cancer Survivors ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Active Smoking ◽  
Current Smoking ◽  
Colorectal Cancer Survivors ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality

Purpose Active smoking is associated with higher colorectal cancer risk, but its association with survival after colorectal cancer diagnosis is unclear. We investigated associations of smoking, before and after diagnosis, with all-cause and colorectal cancer–specific mortality among colorectal cancer survivors. Patients and Methods From a cohort of adults who were initially free of colorectal cancer, we identified 2,548 persons diagnosed with invasive, nonmetastatic colorectal cancer between baseline (1992 or 1993) and 2009. Vital status and cause of death were determined through 2010. Smoking was self-reported on the baseline questionnaire and updated in 1997 and every 2 years thereafter. Postdiagnosis smoking information was available for 2,256 persons (88.5%). Results Among the 2,548 colorectal cancer survivors, 1,074 died during follow-up, including 453 as a result of colorectal cancer. In multivariable-adjusted Cox proportional hazards regression models, prediagnosis current smoking was associated with higher all-cause mortality (relative risk [RR], 2.12; 95% CI, 1.65 to 2.74) and colorectal cancer–specific mortality (RR, 2.14; 95% CI, 1.50 to 3.07), whereas former smoking was associated with higher all-cause mortality (RR, 1.18; 95% CI, 1.02 to 1.36) but not with colorectal cancer–specific mortality (RR, 0.89; 95% CI, 0.72 to 1.10). Postdiagnosis current smoking was associated with higher all-cause (RR, 2.22; 95% CI, 1.58 to 3.13) and colorectal cancer–specific mortality (RR, 1.92; 95% CI, 1.15 to 3.21), whereas former smoking was associated with all-cause mortality (RR, 1.21; 95% CI, 1.03 to 1.42). Conclusion This study adds to the existing evidence that cigarette smoking is associated with higher all-cause and colorectal cancer–specific mortality among persons with nonmetastatic colorectal cancer.

Prostate cancer specific mortality and overall survival outcomes for salvage radiation therapy after radical prostatectomy.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 9-9
Author(s):  
Shree Agrawal ◽  
Jason A. Efstathiou ◽  
Jeff M. Michalski ◽  
Thomas Michael Pisansky ◽  
Bridget F. Koontz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Radical Prostatectomy ◽  
Proportional Hazards ◽  
Distant Metastases ◽  
Cox Proportional Hazards ◽  
Salvage Radiation Therapy ◽  
Specific Mortality ◽  
Completion Date ◽  
Cancer Specific Mortality

9 Background: Early salvage radiation therapy (SRT) following radical prostatectomy (RP) has been shown to reduce biochemical recurrence and distant metastases. We aim to identify factors predictive of prostate cancer-specific mortality (PCSM) and all-cause mortality (ACM) from a consortium database from 10 academic institutions. Methods: 2,454 node-negative patients (pts) with detectable post-prostatectomy PSA ( ≥ 0.01 ng/mL) treated with SRT ± neoadjuvant/concurrent androgen deprivation therapy (N/C ADT) were included. Cumulative incidence and Kaplan-Meier methods were used to estimate rates of PCSM and ACM, respectively. Univariate and multivariable analyses (MVA) were performed by competing risks regression and Cox proportional hazards methods for PCSM and ACM. Results: Median follow-up was 5 years from SRT completion and 8 years from date of RP; 24% had pathologic Gleason score (GS) of ≤ 6, 56% GS 7, and 19% GS ≥ 8; 56% extraprostatic extension (EPE), 18% seminal vesicle invasion (SVI), 58% positive surgical margins, and 16% received N/C ADT. Median age at RP and SRT were 62 years (IQR 56-66) and 64 years (59-69), respectively. Median SRT dose was 66 Gy (IQR 65-68) and median pre-SRT PSA was 0.5 ng/mL (IQR 0.3-1.1). MVA performed from SRT completion date demonstrated higher pre-SRT PSA (HR = 2.1), higher GS (GS 7 vs. ≤ 6: HR 2.0; GS ≥ 8 vs. 6: HR 3.3) , SVI (HR 2.5), year of SRT (2000-2004, 1995-1999, 1985-1994 vs. 2005-2012; HR 2.9, HR 2.5, HR 3.6, respectively) were significantly associated with higher PCSM. These same variables were all significantly associated with higher PCSM and ACM rates calculated from both SRT completion date and date of RP. Conclusions: Initiation of early SRT at lower post-operative PSA levels following RP is associated with reduced risk of PCSM and ACM, even when calculated from RP date to account for lead time bias. Other factors significantly associated with PCSM include higher GS, SVI, and earlier year of SRT. [Table: see text]

Psychological distress and mortality among US adults: prospective cohort study of 330 367 individuals

2020 ◽  
Vol 74 (4) ◽  
pp. 384-390 ◽  
Author(s):  
Lili Yang ◽  
Min Zhao ◽  
Costan G Magnussen ◽  
Sreenivas P Veeranki ◽  
Bo Xi
Keyword(s):  
Psychological Distress ◽  
Dose Response ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Risk Of Mortality ◽  
Specific Mortality ◽  
Interview Survey ◽  
Cancer Specific Mortality

BackgroundPrevious studies have shown inconsistent findings on the association between psychological distress and risk of mortality. This study aimed to address this inconsistent association using a large US population-based cohort.MethodsThis study used data from 1997 to 2009 US National Health Interview Survey, which were linked with National Death Index through 31 December 2011. Psychological distress was measured using Kessler-6 scale and was categorised into six groups based on scores as 0, 1–3, 4–6, 7–9, 10–12 and ≥13. Main outcomes were all-cause, cancer-specific and cardiovascular disease (CVD)-specific mortality. Analyses were completed in 2019. Cox proportional hazards models were used to determine the association between psychological distress and mortality.ResultsA total of 330 367 participants aged ≥18 years were included. During a mean follow-up of 8.2 years, 34 074 deaths occurred, including 8320 cancer-related and 8762 CVD-related deaths. There was a dose–response association between psychological distress and all-cause mortality. Compared with the 0 score category, adjusted HRs (95% CIs) for other categorical psychological distress scores, that is, 1–3, 4–6, 7–9, 10–12 and ≥13, were 1.09 (1.05 to 1.12), 1.22 (1.17 to 1.27), 1.38 (1.31 to 1.46), 1.49 (1.40 to 1.59) and 1.57 (1.47 to 1.68), respectively. Corresponding values for cancer-specific mortality were 1.06 (0.99 to 1.12), 1.13 (1.04 to 1.23), 1.27 (1.14 to 1.42), 1.38 (1.22 to 1.57) and 1.32 (1.15 to 1.51), respectively; those for CVD-specific mortality were 1.11 (1.05 to 1.18), 1.22 (1.12 to 1.32), 1.30 (1.17 to 1.45), 1.38 (1.20 to 1.58), and 1.46 (1.27 to 1.68), respectively.ConclusionsWe found a dose–response relationship between psychological distress and all-cause and cause-specific mortality, emphasising the need for early prevention strategies among individuals with potential psychological distress.

scholarly journals Underweight increases the risk of early death in tuberculosis patients

2017 ◽  
Vol 118 (12) ◽  
pp. 1052-1060 ◽  
Author(s):  
Yung-Feng Yen ◽  
Fu-I Tung ◽  
Bo-Lung Ho ◽  
Yun-Ju Lai
Keyword(s):  
Proportional Hazards ◽  
Early Death ◽  
Cox Proportional Hazards ◽  
Tuberculosis Patients ◽  
Proportional Hazards Regression ◽  
Increased Risk ◽  
Specific Mortality ◽  
Joint Consideration ◽  
The Impact ◽  
Timing Of Death

AbstractEvidence regarding the association between BMI and mortality in tuberculosis (TB) patients is limited and inconsistent. We investigated the impact of BMI on TB-specific and non-TB-specific mortality with respect to different timing of death. All Taiwanese adults with TB in Taipei were included in a retrospective cohort study in 2012–2014. Multinomial Cox proportional hazards regression was used to evaluate the associations between BMI, cause-specific mortality and timing of death. Of 2410 eligible patients, 86·0 % (2061) were successfully treated, and TB-specific and non-TB-specific mortality occurred for 2·2 % (54) and 13·9 % (335), respectively. After controlling for potential confounders, underweight was significantly associated with a higher risk of all-cause mortality (adjusted hazard ratio (AHR) 1·57; 95 % CI 1·26, 1·95), whereas overweight was not. When cause-specific death was considered, underweight was associated with an increased risk of either TB-specific (AHR 1·85; 95 % CI 1·03, 3·33) or non-TB-specific death (AHR 1·52; 95 % CI 1·19, 1·95) during treatment. With joint consideration of cause-specific and timing of death, underweight only significantly increased the risk of TB-specific (AHR 2·23; 95 % CI 1·09, 4·59) and non-TB-specific mortality (AHR 1·81; 95 % CI 1·29, 2·55) within the first 8 weeks of treatment. This study suggests that underweight increases the risk of early death in TB patients during treatment.

Age at Exposure to Parental Suicide and the Subsequent Risk of Suicide in Young People

Crisis ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 27-36 ◽  
Author(s):  
Kuan-Ying Lee ◽  
Chung-Yi Li ◽  
Kun-Chia Chang ◽  
Tsung-Hsueh Lu ◽  
Ying-Yeh Chen
Keyword(s):  
Young People ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Birth Registry ◽  
Data Set ◽  
Parental Suicide ◽  
The Impact ◽  
Age At Exposure

Abstract. Background: We investigated the age at exposure to parental suicide and the risk of subsequent suicide completion in young people. The impact of parental and offspring sex was also examined. Method: Using a cohort study design, we linked Taiwan's Birth Registry (1978–1997) with Taiwan's Death Registry (1985–2009) and identified 40,249 children who had experienced maternal suicide (n = 14,431), paternal suicide (n = 26,887), or the suicide of both parents (n = 281). Each exposed child was matched to 10 children of the same sex and birth year whose parents were still alive. This yielded a total of 398,081 children for our non-exposed cohort. A Cox proportional hazards model was used to compare the suicide risk of the exposed and non-exposed groups. Results: Compared with the non-exposed group, offspring who were exposed to parental suicide were 3.91 times (95% confidence interval [CI] = 3.10–4.92 more likely to die by suicide after adjusting for baseline characteristics. The risk of suicide seemed to be lower in older male offspring (HR = 3.94, 95% CI = 2.57–6.06), but higher in older female offspring (HR = 5.30, 95% CI = 3.05–9.22). Stratified analyses based on parental sex revealed similar patterns as the combined analysis. Limitations: As only register-­based data were used, we were not able to explore the impact of variables not contained in the data set, such as the role of mental illness. Conclusion: Our findings suggest a prominent elevation in the risk of suicide among offspring who lost their parents to suicide. The risk elevation differed according to the sex of the afflicted offspring as well as to their age at exposure.

scholarly journals Association of mushroom consumption with all-cause and cause-specific mortality among American adults: prospective cohort study findings from NHANES III

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Djibril M. Ba ◽  
Xiang Gao ◽  
Joshua Muscat ◽  
Laila Al-Shaar ◽  
Vernon Chinchilli ◽  
...  
Keyword(s):  
Lower Risk ◽  
Proportional Hazards ◽  
Total Mortality ◽  
Cox Proportional Hazards ◽  
Dietary Factors ◽  
Mortality Data ◽  
Nhanes Iii ◽  
Dietary Recall ◽  
All Cause Mortality ◽  
Specific Mortality

Abstract Background Whether mushroom consumption, which is rich in several bioactive compounds, including the crucial antioxidants ergothioneine and glutathione, is inversely associated with low all-cause and cause-specific mortality remains uncertain. This study aimed to prospectively investigate the association between mushroom consumption and all-cause and cause-specific mortality risk. Methods Longitudinal analyses of participants from the Third National Health and Nutrition Examination Survey (NHANES III) extant data (1988–1994). Mushroom intake was assessed by a single 24-h dietary recall using the US Department of Agriculture food codes for recipe foods. All-cause and cause-specific mortality were assessed in all participants linked to the National Death Index mortality data (1988–2015). We used Cox proportional hazards regression models to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for all-cause and cause-specific mortality. Results Among 15,546 participants included in the current analysis, the mean (SE) age was  44.3 (0.5) years. During a mean (SD) follow-up duration of 19.5 (7.4) years , a total of 5826 deaths were documented. Participants who reported consuming mushrooms had lower risk of all-cause mortality compared with those without mushroom intake (adjusted hazard ratio (HR) = 0.84; 95% CI: 0.73–0.98) after adjusting for demographic, major lifestyle factors, overall diet quality, and other dietary factors including total energy. When cause-specific mortality was examined, we did not observe any statistically significant associations with mushroom consumption. Consuming 1-serving of mushrooms per day instead of 1-serving of processed or red meats was associated with lower risk of all-cause mortality (adjusted HR = 0.65; 95% CI: 0.50–0.84). We also observed a dose-response relationship between higher mushroom consumption and lower risk of all-cause mortality (P-trend = 0.03). Conclusion Mushroom consumption was associated with a lower risk of total mortality in this nationally representative sample of US adults.

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