Health behaviors of early-stage non-small cell lung cancer survivors
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Lung cancer survivors are at risk for cancer recurrence and other chronic illnesses related predominantly to prior tobacco use and older age. Optimal quality of post-treatment care requires greater knowledge of survivors’ adherence to behavioral health recommendations. This study reports the rates of smoking, physical activity, alcohol use, cancer screenings, and routine primary care visits in non-small cell lung cancer (NSCLC) survivors.
Stage IA and IB NSCLC survivors (N = 183, mean age = 69.0 years) with no evidence of disease 1–6 years post-treatment completed standard survey items regarding health and cancer screening behaviors.
Most survivors (83.5%) had a history of smoking, but 64.8% quit prior to diagnosis and only 5.5% continued to smoke. Alcohol intake recommendations were exceeded by 5.4% and 17.3% of men and women, respectively. In a typical week, 23.1% met physical activity guidelines. Regarding cancer screenings, 89.3% were adherent to colorectal cancer screening guidelines. Among women, 72.0% had a mammogram within the previous year and 81.5% had a pap test in the previous 3 years; among men, 86.7% had a prostate-specific antigen test in the previous year. Almost all (97.3%) had seen a primary care provider in the past year.
The majority of lung cancer survivors were adherent to health promotion recommendations, but few engaged in the recommended level of physical activity.
Implications for cancer survivors
Physical and pulmonary rehabilitation interventions may help lung cancer survivors maintain sufficient levels of physical activity, which can have numerous benefits for older adults.
- Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2010. CA Cancer Journal for Clinicians. 2010.
- Ries L, Melbert D, Krapcho M, Stinchcomb D, Howlader N, Horner M, et al. SEER Cancer statistics review, 1975–2005. Bethesda: National Cancer Institute; 2008.
- Mountain CF. Revisions in the international system for staging lung cancer. Chest. 1997;111(6):1710–7. CrossRef
- Ko CY, Maggard M, Livingston EH. Evaluating health utility in patients with melanoma, breast cancer, colon cancer, and lung cancer: a nationwide, population-based assessment. J Surg Res. 2003;114(1):1–5. CrossRef
- Feinstein MB, Krebs P, Coups EJ, Park BJ, Steingart RM, Burkhalter J, et al. Current dyspnea among long-term survivors of early-stage non-small cell lung cancer. J Thorac Oncol. 2010;5(8):1221–6. CrossRef
- Sarna L, Padilla G, Holmes C, Tashkin D, Brecht ML, Evangelista L. Quality of life of long-term survivors of non-small-cell lung cancer. J Clin Oncol. 2002;20(13):2920–9. CrossRef
- Hung R, Krebs P, Coups EJ, Feinstein MB, Park BJ, Burkhalter J, et al. Fatigue and functional impairment in early-stage non-small cell lung cancer survivors. J Pain Symptom Manage. 2011;41(2):426–35. CrossRef
- Ostroff JS, Krebs P, Coups EJ, Burkhalter JE, Feinstein MB, Steingart RM, et al. Health-related quality of life among early-stage, non-small cell, lung cancer survivors. Lung Cancer. 2011;71(1):103–8. CrossRef
- Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Medical Sci. 2003;58(1):82–91. CrossRef
- American Cancer Society. Detailed guide: lung cancer–non-small cell. 2008. Available from: http://www.cancer.org. Accessed 5 May 2008.
- Levi F. Second primary cancers in patients with lung carcinoma. Cancer. 1999;86(1):186–90. CrossRef
- Institute of Medicine. From cancer patient to cancer survivor: lost in transition. Washington: Institute of Medicine; 2006.
- Garman KS, Pieper CF, Seo P, Cohen HJ. Function in elderly cancer survivors depends on comorbidities. J Gerontol A Biol Sci Med Sci. 2003;58(12):1119–24. CrossRef
- Seo PH, Pieper CF, Cohen HJ. Effects of cancer history and comorbid conditions on mortality and healthcare use among older cancer survivors. Cancer. 2004;101(10):2276–84. CrossRef
- Garces YI, Yang P, Parkinson J, Zhao X, Wampfler JA, Ebbert JO, et al. The relationship between cigarette smoking and quality of life after lung cancer diagnosis. Chest. 2004;126(6):1733–41. CrossRef
- Baser S. Smoking cessation after diagnosis of lung cancer is associated with a beneficial effect on performance status. Chest. 2006;130(6):1784–90. CrossRef
- Evangelista LS, Sarna L, Brecht ML, Padilla G, Chen J. Health perceptions and risk behaviors of lung cancer survivors. Heart Lung. 2003;32(2):131–9. CrossRef
- Tammemagi CM, Neslund-Dudas C, Simoff M, Kvale P. Smoking and lung cancer survival: the role of comorbidity and treatment. Chest. 2004;125(1):27–37. CrossRef
- Tucker MA, Murray N, Shaw EG, Ettinger DS, Mabry M, Huber MH, et al. Second primary cancers related to smoking and treatment of small-cell lung cancer. J Natl Cancer Inst. 1997;89(23):1782–8. CrossRef
- Bongaerts BWC, Van Den Brandt PA, Goldbohm RA, De Goeij AFPM, Weijenberg MP. Alcohol consumption, type of alcoholic beverage and risk of colorectal cancer at specific subsites. Int J Cancer. 2008;123(10):2411–7. CrossRef
- Chao C. Associations between beer, wine, and liquor consumption and lung cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2007;16(11):2436–47. CrossRef
- Pelucchi C, Gallus S, Garavello W, Bosetti C, La Vecchia C. Alcohol and tobacco use, and cancer risk for upper aerodigestive tract and liver. Eur J Cancer Prev. 2008;17(4):340–4. CrossRef
- Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–26. CrossRef
- Holtzman J, Schmitz KH, Babes G, Kane R, Duval S, Wilt T, et al. Effectiveness of behavioral interventions to modify physical activity behaviors in general populations and cancer patients and survivors. Rockville: Agency for Healthcare Research and Quality; 2004.
- Pinto BM, Trunzo JJ. Health behaviors during and after a cancer diagnosis. Cancer. 2005;104(11 Suppl):2614–23. CrossRef
- Knols R, Aaronson NK, Uebelhart D, Fransen J, Aufdemkampe G. Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol. 2005;23(16):3830–42. CrossRef
- Keating NL, Nørredam M, Landrum MB, Huskamp HA, Meara E. Physical and mental health status of older long-term cancer survivors. J Am Geriatr Soc. 2005;53(12):2145–52. CrossRef
- Humpel N, Magee C, Jones SC. The impact of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends. Support Care Cancer. 2007;15(6):621–30. CrossRef
- Coups EJ, Ostroff JS. A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med. 2005;40(6):702–11. CrossRef
- Mayer DK, Terrin NC, Menon U, Kreps GL, McCance K, Parsons SK, et al. Health behaviors in cancer survivors. Oncol Nurs Forum. 2007;34(3):643–51. CrossRef
- Coups EJ, Park BJ, Feinstein MB, Steingart RM, Egleston BL, Wilson DJ, et al. Physical activity among lung cancer survivors: changes across the cancer trajectory and associations with quality of life. Cancer Epidemiol Biomarkers Prev. 2009;18(2):664–72. CrossRef
- Earle CC, Neville BA. Under use of necessary care among cancer survivors. Cancer. 2004;101(8):1712–9. CrossRef
- Shenson D, Bolen J, Adams M, Seeff L, Blackman D. Are older adults up-to-date with cancer screening and vaccinations? Prev Chronic Dis. 2005;2(3):A04 (electronic resource).
- Folstein MF, Folstein SE, McHugh PR. Mini mental state. A practical method for grading the cognitive state of patients for the clinician. J Psych Res. 1975;12(3):189–98. CrossRef
- CDC (Centers for Disease Control and Prevention). Behavioral Risk Factor Surveillance System Survey Questionnaire. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2005.
- CDC (Centers for Disease Control and Prevention). National Health Interview Survey. Atlanta, GA: National Center for Health Statistics, Centers for Disease Control and Prevention; 2005.
- NCI (National Cancer Institute). Health Information National Trends Survey (HINTS). Bethesda, MD: Division of Cancer Control and Population Sciences (DCCPS), National Cancer Institute; 2005.
- Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985;10(3):141–6.
- SAS Institute. SAS v9.1. Cary, NC: SAS Institute Inc.; 2007.
- ACS (American Cancer Society). American Cancer Society Guidelines for the Early Detection of Cancer. 2008. http://www.cancer.org. Accessed 2 June 2008.
- Preventive Services US. Task force. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149:627–37.
- U.S. Department of Health and Human Services. Physical activity guidelines for Americans. Washington, DC: U.S. Department of Health and Human Services, Office of Disease Prevention; 2008. http://www.health.gov/paguidelines/factsheetprof.aspx. Accessed 10 Nov 2008.
- U.S. Preventive Services Task Force. Screening for breast cancer: recommendations and rationale, 2002. Rockville, MD: Agency for Healthcare Research and Quality.
- American Heart Association. Heart Disease and Stroke Statistics—2008 update. Dallas, TX: American Heart Association/American Stroke Association; 2008.
- Centers for Disease Control and Prevention (CDC). Use of colorectal cancer tests—United States, 2002, 2004, and 2006. MMWR. 2008;57(10):253–8.
- CDC (Centers for Disease Control and Prevention). Mammograms within 2 years, age 40+, nationwide, 2006. Behavioral risk factor surveillance system. http://www.cdc.gov/brfss/. Accessed 12 Nov 2008.
- CDC (Centers for Disease Control and Prevention). Prostate cancer screening nationwide, 2006. Behavioral risk factor surveillance system. Bethesda, MD. http://www.cdc.gov/brfss/. Accessed 12 Nov 2008.
- Solomon D, Breen N, McNeel T. Cervical cancer screening rates in the United States and the potential impact of implementation of screening guidelines. CA Cancer J Clin. 2007;57(2):105–11. CrossRef
- American Cancer Society. Cancer facts and figures 2009. Atlanta, GA: American Cancer Society.
- National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health. http://www.diabetes.niddk.nih.gov/dm/pubs/statistics/. Accessed 27 Nov 2008.
- Bellizzi KM, Rowland JH. Role of comorbidity, symptoms and age in the health of older survivors following treatment for cancer. J Aging Health. 2007;3(5):625–35. CrossRef
- Rubins J, Unger M, Colice GL. Follow-up and surveillance of the lung cancer patient following curative intent therapy: ACCP evidence-based clinical practice guideline (2nd edition). Chest. 2007;132(3 Suppl):355S–67S. CrossRef
- Oeffinger KC, McCabe MS. Models for delivering survivorship care. J Clin Oncol. 2006;24(32):5117–24. CrossRef
- Sugimura H, Yang P. Long-term survivorship in lung cancer: a review. Chest. 2006;129(4):1088–97. CrossRef
- Ganz PA. Monitoring the physical health of cancer survivors: a survivorship-focused medical history. J Clin Oncol. 2006;24(32):5105–11. CrossRef
- Health behaviors of early-stage non-small cell lung cancer survivors
Journal of Cancer Survivorship
Volume 6, Issue 1 , pp 37-44
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Health behavior
- Cancer screening
- Lung cancer
- Industry Sectors
- Author Affiliations
- 1. Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- 7. New York University School of Medicine, Division of General Internal Medicine, 423 23rd Street, 15th Floor, New York, NY, 10010, USA
- 2. The Cancer Institute of New Jersey, Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- 3. Department of Health Education and Behavioral Science, UMDNJ-School of Public Health, New Brunswick, NJ, USA
- 4. Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- 5. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- 6. Department of Thoracic Surgery, Hackensack University Medical Center, New York, NY, USA