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Whereas some patients have an indolent disease, others experience an aggressive course and early death. Our aim was to investigate if modifiable and non\u2010modifiable medical history and lifestyle factors prior to diagnosis had an impact on the natural course of the disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In 1154 CLL patients, we assessed if the weight, physical activity, smoking, and alcohol consumption or non\u2010modifiable characteristics including family history of lymphoid malignancy and medical history were associated with time\u2010to\u2010first\u2010treatment (TTFT) and adjusted all results for the CLL\u2010International Prognostic Index (CLL\u2010IPI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>TTFT was shorter for patients with high\/very high\u2010risk CLL\u2010IPI than those with low\/intermediate risk CLL\u2010IPI. In the adjusted analysis we did not find additional impact on TTFT besides CLL\u2010IPI from any environmental characteristics assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found limited impact of environmental factors on the natural course of CLL (measured as the TTFT in treatment na\u00efve patients) providing valuable knowledge, and potential relief, to share with patients at the time of diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jha2.1000","type":"journal-article","created":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T13:24:34Z","timestamp":1724765074000},"page":"998-1004","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Medical history and lifestyle factors have limited impact on time\u2010to\u2010first\u2010treatment in patients with chronic lymphocytic leukemia"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6158-3041","authenticated-orcid":false,"given":"Ingrid","family":"Glimelius","sequence":"first","affiliation":[{"name":"Department of Immunology, Genetics &amp; Pathology, Cancer Precision Medicine Uppsala University  Uppsala Sweden"},{"name":"Department of Medicine Solna Division of Clinical Epidemiology Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geffen","family":"Kleinstern","sequence":"additional","affiliation":[{"name":"School of Public Health University of Haifa  Haifa Israel"},{"name":"Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis P.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota 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Utoft","family":"Niemann","sequence":"additional","affiliation":[{"name":"Danish Cancer Society Research Center Danish Cancer Society  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattias","family":"Mattsson","sequence":"additional","affiliation":[{"name":"Department of Immunology, Genetics &amp; Pathology, Cancer Precision Medicine Uppsala University  Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kari G.","family":"Rabe","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1292-3024","authenticated-orcid":false,"given":"Paul J.","family":"Hampel","sequence":"additional","affiliation":[{"name":"Department of Hematology, Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer 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