Letter to the editor: "Mediation effect of healthy lifestyles on the association of socioeconomic status with mortality among US cancer survivors: a population-based cohort study".

Data from Supplementary Table 3 demonstrates highly unequal contributions of individual lifestyle factors to mortality risk: no heavy alcohol drinking (hazard ratio [HR] = 1.15, 95% confidence interval [CI]: 0.78–1.68, P = 0.484) and healthy diet (HR = 0.88, 95% CI: 0.74–1.06, P = 0.185) were not statistically significant; never smoking showed only marginal significance (HR = 0.83, 95% CI: 0.68–1.02, P = 0.071); only physical activity demonstrated a consistently strong effect (HR = 0.57, 95% CI: 0.47–0.70, P < 0.001).

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These mediation effects did not reach statistical significance or exceed the practical significance threshold (10%), providing insufficient evidence for a clinically meaningful mediating role of healthy lifestyles in the association between SES and mortality among non-White cancer survivors.

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