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Health behaviors among breast, prostate, and colorectal cancer survivors: a US population-based case-control study, with comparisons by cancer type and gender

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Abstract

Purpose

The aim of this study is to compare health behaviors between breast, prostate, female, and male colorectal cancer survivors to noncancer controls, stratified by short- and long-term survivors, and between cancer types and genders.

Methods

A 3:1 population-based sample of breast (6,259), prostate (3,609), female colorectal (1,082), and male colorectal (816) cancer survivors from the 2009 Behavioral Risk Factor Surveillance System survey were matched to noncancer controls on age, gender, race/ethnicity, income, insurance, and region of the US. The likelihood of flu immunization, physical check-up, cholesterol check, body mass index (BMI), physical activity, diet (5-A-Day), smoking, and alcohol use were compared between groups using binomial logistic regression models.

Results

Short-term breast cancer survivors were significantly more likely to meet multiple behavioral recommendations, than controls, but the likelihood decreased in the long term. Breast and female colorectal cancer survivors were up to 2.27 (95 % CI 1.90, 2.71) and 1.89 times more likely (95 % CI 1.60, 2.24) to meet the 5-A-Day and BMI recommendations, up to 0.54 times less likely (95 % CI 0.46, 0.64) to drink any alcohol, but were 0.68 times less likely (95 % CI 0.49, 0.95) to meet the physical activity recommendation, compared to prostate and male colorectal cancer survivors.

Conclusions

Some cancer survivors may engage in better health behaviors shortly after diagnosis, but the majority of cancer survivors do not have better health behaviors than individuals without a history of cancer. However, a consistent pattern of behavioral differences exist between male and female cancer survivors.

Implications for Cancer Survivors

Gender differences in health behaviors among cancer survivors may be influenced by perceptions of masculinity/femininity and disease risk. Ongoing health behavioral promotion and disease prevention efforts could be improved by addressing these perceptions.

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References

  1. Crawford AG, Cote C, Couto J, et al. Prevalence of obesity, type II diabetes mellitus, hyperlipidemia, and hypertension in the United States: findings from the GE centricity electronic medical record database. Popul Health Manag. 2009;13:151–61.

    Article  Google Scholar 

  2. Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011;13:1–9.

    Article  Google Scholar 

  3. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observations studies. Lancet. 2008;371:569–78.

    Article  PubMed  Google Scholar 

  4. Weaver KE, Foraker RE, Alfano CM, et al. Cardiovascular risk factors among long-term survivors of breast, prostate, colorectal, and gynecologic cancers: a gap in survivorship care? J Cancer Surviv. 2013;7:253–61.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Bellizzi KM, Rowland JH, Jeffery DD, McNeel T. Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol. 2005;23:8884–93.

    Article  PubMed  Google Scholar 

  6. Eakin EG, Youlden DR, Baade PD, et al. Health behaviors of cancer survivors: data from an Australian population-based survey. Cancer Causes Control. 2007;18:881–94.

    Article  PubMed  Google Scholar 

  7. Howlader N, Noone AM, Krapcho M, et al. Estimated United States cancer prevalence. SEER Cancer statistics review, 1975–2008. Bethesda: National Cancer Institute; 2011. http://seer.cancer.gov/csr/1975_2008/. Accessed 29 July 2013.

    Google Scholar 

  8. Smith AW, Reeve BB, Bellizzi KM, et al. Cancer, comorbidities, and health-related quality of life of older adults. Health Care Financ Rev. 2008;29(4):41–56.

    PubMed Central  PubMed  Google Scholar 

  9. Rock CL, Doyle C, Denmark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62:423–74.

    Article  Google Scholar 

  10. U.S. Preventive Services Task Force. The guide to clinical preventive services 2010–2011: Recommendations of the U.S. Preventive Services Task Force. Rockville: Agency for Healthcare Research and Quality; 2010. Aug. Report No. 10-05145. http://www.ahrq.gov/clinic/uspstfix.htm. Accessed 29 July 2013.

    Google Scholar 

  11. Centers for Disease Control and Prevention. Recommended adult immunization schedule–United States, 2011. MMWR Morbidity and Mortality Weekly Report. 2011;60:1–4.

  12. Coups EJ, Ostroff JS. A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. J Prev Med. 2005;40:702–11.

    Article  Google Scholar 

  13. Kim RB, Phillips A, Herrick K, et al. Physical activity and sedentary behavior of cancer survivors and non-cancer individuals: results from a national survey. Public Lib Sci One J. 2013;8(3):e57598.

    CAS  Google Scholar 

  14. Moon SH, Lee DT, Son Y. Adherence to health-related lifestyle behavior recommendations and association with quality of life among cancer survivors and age-matched controls in Korea. Asian Pac J Cancer Prev. 2013;14(5):2949–54.

    Article  PubMed  Google Scholar 

  15. Khan NF, Carpenter L, Watson E, Rose PW. Cancer screening and preventive care among long-term cancer survivors in the United Kingdom. Br J Cancer. 2010;102:1085–90.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Snyder CF, Frick KD, Peairs KS, et al. Comparing care for breast cancer survivors to non-cancer controls: a five-year longitudinal study. J Gen Intern Med. 2009;24(4):469–74.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Blanchard CM, Courneya KS, Stein K. Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. J Clin Oncol. 2008;26:2198–204.

    Article  PubMed  Google Scholar 

  18. Azevedo MR, Araujo CL, Reichert FF, Siqueira FV, da Silva MC, Hallal PC. Gender differences in leisure-time physical activity. Int J Public Health. 2007;52:8–15.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Prättälä R, Paalanen L, Grinberga D, Helasoja V, Kasmel A, Petkeviciene J. Gender differences in the consumption of meat, fruit and vegetables are similar in Finland and the Baltic countries. Eur J Pub Health. 2007;17:520–5.

    Article  Google Scholar 

  20. Wilsnack RW, Wilsnack SC, Kristjanson AF, Vogeltanz-Holm ND, Gmel G. Gender and alcohol consumption: patterns from the multinational GENACIS project. Addiction. 2009;104(9):1487–500.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Centers for Disease Control and Prevention (CDC). Behavioral risk factor surveillance system survey data. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2009.

    Google Scholar 

  22. Centers for Disease Control and Prevention (CDC). BRFSS codebook. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2009. http://www.cdc.gov/brfss/technical_infodata/surveydata/2009.htm#survey. Accessed 29 July 2013.

    Google Scholar 

  23. Centers for Disease Control and Prevention (CDC). Summary data quality report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2009. http://www.cdc.gov/brfss/technical_infodata/quality.htm. Accessed 29 July 2013.

    Google Scholar 

  24. Brown JK, Byers T, Doyle C, et al. Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin. 2003;53:268–91.

    Article  PubMed  Google Scholar 

  25. Earle CC, Neville BA. Under use of necessary care among cancer survivors. Cancer. 2004;101:1712–8.

    Article  PubMed  Google Scholar 

  26. Gjerset GM, Fossa SD, Courneya KS, Skovlund E, Thorsen L. Exercise behavior in cancer survivors and associated factors. J Cancer Surviv. 2011;5:35–43.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Jansen L, Herrmann A, Stegmaier C, Singer S, Brenner H, Arndt V. Health-related quality of life during the 10 years after diagnosis of colorectal cancer: a population-based study. J Clin Oncol. 2001;29:3263–9.

    Article  Google Scholar 

  28. Krouse RS, Herrinton LJ, Grant M, et al. Health-related quality of life among long-term rectal cancer survivors with an ostomy: manifestations by sex. J Clin Oncol. 2009;27:4664–70.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Mosher CE, Sloane R, Morey MC, et al. Associations between lifestyle factors and quality of life among older long-term breast, prostate, and colorectal cancer survivors. Cancer. 2009;115:4001–9.

    Article  PubMed Central  PubMed  Google Scholar 

  30. McDonnell LA, Riley DL, Blanchard CM, et al. Gender differences in satisfaction with life in patients with coronary heart disease: physical activity as a possible mediating factor. J Behav Med. 2011;34:192–200.

    Article  PubMed  Google Scholar 

  31. Wardle J, Haase AM, Steptoe A. Gender differences in food choice: the contribution of health beliefs and dieting. Ann Behav Med. 2004;27:107–16.

    Article  PubMed  Google Scholar 

  32. Courtenay WH. Constructions of masculinity and their influence on men’s well-being: a theory of gender and health. Soc Sci Med. 2000;50:1385–401.

    Article  CAS  PubMed  Google Scholar 

  33. Gough B, Conner MT. Barriers to health eating amongst men: a qualitative analysis. Soc Sci Med. 2006;62:387–95.

    Article  PubMed  Google Scholar 

  34. Rosenstock IM. The health belief model and preventive health behavior. Health Educ Monogr. 1974;2:354–86.

    Google Scholar 

  35. Kochanek KD, Xu JQ, Murphy SL, Miniño AM, Kung HC. Deaths: final data for 2009. Natl Vital Stat Rep. 2011;60:1–117.

    PubMed  Google Scholar 

  36. Mosca L, Mochari-Greenberger H, Dolor RJ, Newby LK, Robb KJ. Twelve-year follow-up of American women’s awareness of cardiovascular disease risk and barriers to heart health. Circ Cardiovasc Qual Outcomes. 2010;3:120–7.

    Article  PubMed Central  PubMed  Google Scholar 

  37. LeMasters T, Madhavan M, Sambamoorthi U, Kurian S. A population-based study comparing HRQoL among breast, prostate, and colorectal cancer survivors to propensity score matched controls, by cancer type, and gender. Psychooncology. 2013;22:2270–82.

    PubMed  Google Scholar 

  38. Demark-Wahnefried W, Morey MC, Sloane R, et al. Reach out to enhance wellness home-based diet-exercise intervention promotes reproducible and sustainable long-term improvements in health behaviors, body weight, and physical functioning in older, overweight/obese cancer survivors. J Clin Oncol. 2012;30:2354–61.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Scott E, Daley AJ, Doll H, et al. Effects of an exercise and hypocaloric healthy eating program on biomarkers associated with long-term prognosis after early-stage breast cancer: a randomized controlled trial. Cancer Causes Control. 2013;1:181–91.

    Article  Google Scholar 

  40. Cowens-Alvarado R, Sharpe K, Pratt-Chapman M, et al. Advancing survivorship care through the National Cancer Survivorship Resource Center: developing American Cancer Society guidelines for primary care providers. CA Cancer J Clin. 2013;63:147–50.

    Article  PubMed  Google Scholar 

  41. Segar M, Jayaratne T, Hanlon J, Richardson CR. Fitting fitness into women’s lives: effects of a gender-tailored physical activity intervention. Women Health Issues. 2002;12:338–47.

    Article  Google Scholar 

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Acknowledgments

The authors would like to acknowledge that this study was funded by the WV CoHORTS Center and AHRQ grant # 1R24H5018622-01.

Conflict of interest

The authors of this study have no conflict of interest to report.

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Authors and Affiliations

  1. Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA

    Traci J. LeMasters, Sundareswaran S. Madhavan & Usha Sambamoorthi

  2. 1614 Mary Babb Randolph Cancer Center, West Virginia University, P.O Box 9162, Morgantown, WV, 26506-9300, USA

    Sobha Kurian

  3. SoP Pharmaceutical Systems and Policy, Robert C. Byrd Health Sciences Center, P.O. Box 9510, Morgantown, WV, 26506-9510, USA

    Traci J. LeMasters, Sundareswaran S. Madhavan & Usha Sambamoorthi

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  1. Traci J. LeMasters
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Correspondence to Traci J. LeMasters.

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LeMasters, T.J., Madhavan, S.S., Sambamoorthi, U. et al. Health behaviors among breast, prostate, and colorectal cancer survivors: a US population-based case-control study, with comparisons by cancer type and gender. J Cancer Surviv 8, 336–348 (2014). https://doi.org/10.1007/s11764-014-0347-5

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  • DOI: https://doi.org/10.1007/s11764-014-0347-5

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