Supportive Care in Cancer

, Volume 16, Issue 10, pp 1097–1104 | Cite as

Health behaviors of Australian colorectal cancer survivors, compared with noncancer population controls

  • Anna L. HawkesEmail author
  • Brigid M. Lynch
  • Danny R. Youlden
  • Neville Owen
  • Joanne F. Aitken
Supportive Care International



A better understanding of health behaviors after a cancer diagnosis is important, as these behaviors are related to physical functioning, disease recurrence, development of second primary cancers, and risk of other chronic diseases. Body weight and health behaviors (smoking status, alcohol consumption, and physical activity) were examined in a population-based sample of colorectal cancer survivors and compared to a matched population group.

Materials and methods

Data were collected by telephone interviews pre-diagnosis (retrospectively reported), 6 and 12 months post-diagnosis for colorectal cancer survivors (n = 1,250). Comparison data were from a population-based cancer risk survey (n = 6,277).


Colorectal cancer survivors were most likely to be overweight/obese pre-diagnosis (66%) than at 6 months (54%) or 12 months post-diagnosis (61%). There was little variation from 6 to 12 months in the proportion of current smokers (7% and 8%, respectively) or high-risk drinkers (both 22%). The greatest changes were for physical activity, with 53% of survivor’s sufficiently active pre-diagnosis, 32% at 6 months, and 38% at 12 months post-diagnosis. At 12 months, colorectal cancer survivors were more likely than the comparison group to be: underweight (OR = 2.14, 95% CI = 1.38–3.31); a former smoker (OR = 1.44, 95% CI = 1.26–1.63); a low-risk (OR = 1.25, 95% CI = 1.09–1.44) or high-risk drinker (OR = 1.70, 95% CI = 1.43–2.03); and insufficiently active (OR = 1.57, 95% CI = 1.34–1.83) or inactive (OR = 2.76, 95% CI = 2.39–3.19). However, colorectal cancer survivors were significantly less likely to be a current smoker (OR = 0.68, 95% CI = 0.54–0.85).


Our findings show particular scope for physical activity interventions for colorectal cancer survivors. Improving the general health of cancer survivors should help to decrease morbidity in this population and associated health system expenditure.


Colorectal neoplasms Cancer Health behavior Survivorship 



This project was funded by The Cancer Council Queensland.


  1. 1.
    Agresti A (1990) Categorical data analysis. Wiley, New YorkGoogle Scholar
  2. 2.
    Australian Institute of Health and Welfare (2003) The active Australia survey: a guide and manual for implementation, analysis and reporting. AIHW, CanberraGoogle Scholar
  3. 3.
    Ball K, Owen N, Salmon J, Bauman A, Gore C (2001) Associations of physical activity with body weight and fat in men and women. Int J Obesity 25:914–919CrossRefGoogle Scholar
  4. 4.
    Bauman A, Armstrong T, Davies J et al (2003) Trends in physical activity participation and the impact of integrated campaigns among Australian adults, 1997–99. Aust NZ J Public Health 27:76–79CrossRefGoogle Scholar
  5. 5.
    Bellizzi K, Rowland J, Jeffery D, NcNeel T (2005) Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol 23:8884–8893PubMedCrossRefGoogle Scholar
  6. 6.
    Brown J, Byers T, Doyle C et al (2003) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin 53:268–291PubMedGoogle Scholar
  7. 7.
    Brown W, Trost S, Bauman A, Mummery K, Owen N (2004) Test-retest reliability of four physical activity measures used in population surveys. J Sci Med Sport 7:205–215PubMedCrossRefGoogle Scholar
  8. 8.
    Coups E, Ostroff J (2005) A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med 40:702–711PubMedCrossRefGoogle Scholar
  9. 9.
    Courneya K, Friedenreich C (1997) Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. J Altern Complement Med 3:215–226PubMedCrossRefGoogle Scholar
  10. 10.
    Courneya K (2003) Exercise in cancer survivors: an overview of research. Med Sci Sport Exer 35:1846–1852CrossRefGoogle Scholar
  11. 11.
    Demark-Wahnefried W, Aziz N, Rowland J, Pinto B (2005) Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol 23:5814–5830PubMedCrossRefGoogle Scholar
  12. 12.
    Demark-Wahnefried W, Pinto B, Gritz E (2006) Promoting health and physical function among cancer survivors: potential for prevention and questions that remain. J Clin Oncol 24:5125–5131PubMedCrossRefGoogle Scholar
  13. 13.
    Dimeo F, Stieglitz R, Novelli-Fischer U, Fetscher S, Keul J (1999) Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy. Cancer 85:2273–2277PubMedCrossRefGoogle Scholar
  14. 14.
    DiSipio T, Rogers C, Newman B et al (2006) The Queensland Cancer Risk Study: behavioral risk factor results. Aust NZ J Public Health 30:375–382CrossRefGoogle Scholar
  15. 15.
    Doyle C, Kushi L, Byers T et al (2006) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Can J Clin 56:323–353CrossRefGoogle Scholar
  16. 16.
    Eakin E, Youlden D, Baade P et al (2007) Health behaviors of cancer survivors: data from an Australian population-based survey. Cancer Causes Control 18:881–894PubMedCrossRefGoogle Scholar
  17. 17.
    Ferlay J, Bray F, Pisani P, Parkin D (2004) GLOBOCAN 2002: Cancer incidence, mortality and prevalence worldwide. IARC Press, LyonGoogle Scholar
  18. 18.
    Humpel N, Magee C, Jones S (2007) The impact of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends. Support Care Cancer 15:621–630PubMedCrossRefGoogle Scholar
  19. 19.
    International Agency for Research on Cancer (2001) Weight control and physical activity. IARC Press, LyonGoogle Scholar
  20. 20.
    James A, Campbell M, DeVellis B, Reedy J, Carr C, Sandler R (2006) Health behavior correlates among colon cancer survivors: NC STRIDES baseline results. Am J Health Behav 30:720–730PubMedGoogle Scholar
  21. 21.
    Jemal A, Murrary T, Ward E et al (2005) Cancer statistics, 2005. CA Can J Clin 55:10–30Google Scholar
  22. 22.
    Jones L, Demark-Wahnefried W (2006) Diet, exercise and coomplementary therapies after primary treatment for cancer. Lancet Oncol 7:1017–1026PubMedCrossRefGoogle Scholar
  23. 23.
    Lynch BM, Owen N, Newman B et al (2006) Reliability of a measure of pre-diagnosis physical activity for cancer survivors. Med Sci Sport Exer 38:715–719CrossRefGoogle Scholar
  24. 24.
    Lynch BM, Baade P, Fritschi L et al (2007) Modes of presentation and pathways to diagnosis of colorectal cancer in Queensland. Med J Aust 186:288–291PubMedGoogle Scholar
  25. 25.
    Maunsell E, Drolet M, Brisson J, Robert J, Deschenes L (2002) Dietary change after breast cancer: extent, predictors, and relation with psychological distress. J Clin Oncol 20:1017–1025PubMedCrossRefGoogle Scholar
  26. 26.
    Meyerhardt J, Giovannucci E, Holmes M et al (2006) Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24:3527–3534PubMedCrossRefGoogle Scholar
  27. 27.
    Meyerhardt J, Heseltine D, Niedzwiecki D et al (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24:3535–3541PubMedCrossRefGoogle Scholar
  28. 28.
    Patterson R, Neuhouser M, Hedderson M, Schwartz S, Standish L, Bowen D (2003) Changes in diet, physical activity and supplement use among adults diagnosed with cancer. J Am Diet Assoc 103:323–328PubMedGoogle Scholar
  29. 29.
    Pinto B, Eakin E, Maruyama N (2000) Health behavior changes after a cancer diagnosis: what do we know and where do we go from here. Ann Behav Med 22:38–52PubMedCrossRefGoogle Scholar
  30. 30.
    Pinto B, Trunzo J, Reiss P, Shiu S (2002) Exercise participation after diagnosis of breast cancer: trends and effets on mood and quality of life. Psycho-oncology 11:389–400PubMedCrossRefGoogle Scholar
  31. 31.
    Sallis J, Saelens B (2000) Assessment of physical activity by self-report: status, limitations, and future directions. Res Q Exerc Sport 71:1–14Google Scholar
  32. 32.
    Satia J, Campbell M, Galanko J, James A, Carr C, Sandler R (2004) Longitudinal changes in lifestyle behaviors and health status in colon cancer survivors. Cancer Epidem Biomar 13:1022–1031Google Scholar
  33. 33.
    The Cancer Council Australia (2004) National cancer prevention policy 2004–06. The Cancer Council Australia, SydneyGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Anna L. Hawkes
    • 1
    • 2
    Email author
  • Brigid M. Lynch
    • 1
  • Danny R. Youlden
    • 1
  • Neville Owen
    • 3
  • Joanne F. Aitken
    • 1
  1. 1.Viertel Centre for Research in Cancer ControlThe Cancer Council QueenslandSpring Hill, BrisbaneAustralia
  2. 2.School of Public Health, Tropical Medicine and Rehabilitation SciencesJames Cook UniversityDouglasAustralia
  3. 3.Cancer Prevention Research Centre, School of Population HealthThe University of QueenslandBrisbaneAustralia

Personalised recommendations