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Joann Kiebach

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Open access Aug 2026

Fruit and vegetable consumption, dietary and plasma carotenoids and risks of recurrence and progression in patients with non-muscle-invasive bladder cancer

Fruit and vegetable consumption may decrease bladder cancer risk, but research on its relation to outcomes of non-muscle-invasive bladder cancer (NMIBC) is scarce. We investigated the association of (changes in) pre- and postdiagnosis fruit and vegetable consumption, as well as postdiagnosis dietary and plasma carotenoids, with risks of recurrence and progression in patients with NMIBC. Data from patients with newly diagnosed NMIBC between 2014 and 2021 from the prospective multi-centre cohort UroLife was used. Patients reported prediagnosis diet (n = 1396), and diet at 3 and 15 months postdiagnosis (n = 1270). Plasma carotenoid concentrations were measured at 3 and 15 months postdiagnosis (n = 910). Multivariable proportional hazards regression analyses were performed to assess associations with risks of first recurrence, multiple recurrences, and progression. Median follow-up time was 4.7 years, 466 patients had at least one recurrence, 139 had multiple recurrences, and 153 showed progression. Total fruit and vegetable consumption at 3 months postdiagnosis as well as pre-to-postdiagnosis increases in consumption were inversely associated with first recurrence risk (per 100 g/day: hazard ratio [HR] = 0.91, 95% confidence interval ([95%CI] 0.85–0.99 and HR = 0.90, 95%CI 0.81–0.99, respectively). Results were attenuated at 15 months after diagnosis. Total and individual dietary and plasma carotenoids were not associated with first recurrence risk. No associations with multiple recurrences and progression, and for prediagnosis fruit and vegetable consumption were found. Higher postdiagnosis fruit and vegetable consumption may have a beneficial role in NMIBC recurrence but not progression risk while no associations for dietary and plasma carotenoids were found.

A. Vrieling, Joann Kiebach, M. Balvers et al. · 0 citations
Open access Aug 2026

Lifestyle and dietary inflammation scores and risks of recurrence and progression among patients with non-muscle invasive bladder cancer.

A healthy lifestyle and diet may improve outcomes of patients with non-muscle invasive bladder cancer (NMIBC), potentially through reducing systemic inflammation. Therefore, this study investigated the association of a post-diagnosis Lifestyle (LIS) and Dietary Inflammation Score (DIS), and high-sensitivity C-reactive protein (hsCRP) with the risks of NMIBC recurrence and progression. Patients with newly diagnosed NMIBC between 2014 and 2021 were recruited for the prospective multi-center cohort UroLife. Lifestyle (n = 1334) and/or diet (n = 1306) were self-reported at 3 months post-diagnosis using lifestyle and food frequency questionnaires. The LIS and DIS were calculated to capture the inflammatory potential of lifestyle and diet; higher scores indicate more pro-inflammatory exposures. Plasma hsCRP was measured at 3 months postdiagnosis. The association of LIS and DIS with hsCRP was ascertained in multivariable linear regression models. The association of the LIS, DIS, and hsCRP with risks of first or multiple recurrence(s), and stage and/or grade progression was assessed using multivariable Cox proportional hazards models. Over a median follow-up time of 4.7 years, 466 patients had at least one recurrence, and 155 had progression. Each 1-point increment in LIS and DIS was associated with a 43% (95% CI 29%-58%) and 6% (95% CI 3%-10%) increase in hsCRP, respectively. Higher LIS, DIS, and hsCRP were not associated with risks of first or multiple recurrence(s), and progression. In conclusion, a pro-inflammatory lifestyle and diet, and systemic inflammation, as measured by hsCRP, were not associated with NMIBC outcomes in our cohort. Yet, contributions from specific inflammatory processes or other biomarkers cannot be excluded.

Joann Kiebach, Claire S A D Kamps, E. Wesselink et al. · 0 citations

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