Health Behaviors of Cancer Survivors: Examining Opportunities for Cancer Control Intervention

TLDR

Cancer survivors live longer and face risks of recurrence and late treatment effects, making the study of their health behaviors essential for guiding oncologists in promoting healthy lifestyles. This study used the National Health Interview Survey to compare smoking, alcohol use, physical activity, and cancer screening rates among 7,384 survivors with 121,347 noncancer controls and to establish benchmark prevalence by age, time since diagnosis, and cancer site. A population-based analysis assessed the prevalence of these health behaviors in survivors across age groups, time since diagnosis, and cancer site. Survivors were 9% more likely to meet physical activity guidelines, younger survivors (18–40) had higher smoking rates, women were 34–36% more likely to receive mammogram and Pap smear screening, and screening patterns for PSA were similar in men, with no time‑since‑diagnosis differences but site‑specific variations.

Abstract

A population-based investigation was conducted to examine the prevalence of health behaviors (smoking, alcohol use, physical activity, and cancer screening) of cancer survivors by age, time since diagnosis, and cancer site. Understanding health behaviors of survivors is imperative, as many survivors are living longer and are at risk for cancer recurrence, second cancers, and complications from treatment.Using the National Health Interview Survey, this study examined the prevalence of smoking and alcohol use as well as whether cancer survivors (n = 7,384) are meeting current recommendations for physical activity and cancer screening compared with noncancer controls (n = 121,347).Cancer survivors are similar to controls with respect to smoking status and alcohol consumption after adjusting for group differences. However, younger survivors (18 to 40 years) are at greater risk for continued smoking than controls. Survivors are 9% more likely to meet physical activity recommendations compared with controls. chi2 tests indicate no significant differences in smoking, alcohol consumption, and physical activity by time since diagnosis, but differences by cancer site exist. Female cancer survivors are 34% and 36% more likely to meet mammogram and Papanicolaou smear screening recommendations, respectively, compared with controls. Similar screening patterns were found for prostate-specific antigen screening in men.This study provides benchmark approximations of the prevalence of risky health behaviors of survivors by time since diagnosis and cancer site. As part of the collective effort to reduce late effects of cancer treatment, oncologists may be in the best position to offer initial guidance for promoting healthy lifestyle behaviors among cancer survivors.