With increases in cancer survival, promotion of healthy lifestyle behaviors among survivors is receiving considerable attention. This study compared health behaviors among a large sample of Australian adult cancer survivors with an age- and sex-matched cohort of people with no cancer history.
Using the Australian National Health Survey, 968 cancer survivors were identified, and randomly matched by age and sex to 5,808 respondents without a history of cancer. Six health behaviors were compared (smoking, physical activity, servings of vegetables, servings of fruit, alcohol use, skin checks), along with overweight and obesity, using polytomous logistic regression analyses controlling for selected chronic conditions. Models were applied across both groups and by tumor site.
Compared to the non-cancer comparison group, cancer survivors were significantly more likely to be current (OR = 1.35) smokers, particularly those under 40 years (OR = 1.69), and more likely to have regular skin checks (OR = 1.76). Although not significant, there was consistent evidence that cancer survivors were slightly more likely to be overweight or obese (p = 0.065) and have higher levels of alcohol consumption (p = 0.088). There was no evidence of differences between survivors and controls for levels of physical inactivity, vegetable consumption or fruit consumption. Women with a history of gynecological cancers were much more likely to be current smokers (OR = 2.37), while other differences by sex and cancer site were consistent with overall patterns. Cancer survivors were also significantly more likely to report having a range of co-morbid chronic medical conditions.
Given their increased risk of second cancers and co-morbid chronic conditions, the lack of difference in behavioral risk factors confirms the need for a focus on improving the health behaviors of cancer survivors. Collaborative chronic disease management models may be particularly appropriate in this regard.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Stewart BW, Kleihues P (2003) World cancer report. International Agency for Research on Cancer, Lyon
Hewitt M, Greenfield S, Stovall E (2006) From cancer patient to cancer survival: lost in transition. National Academies Press, Washington, DC
Australian Bureau Statistics (2002) National health survey: summary of results. ABS, Canberra
Mathers CD, Vos ET, Stevenson CE, Begg SJ (2000) The Australian burden of disease study: measuring the loss of health from diseases, injuries and risk factors. Med J Aust 172:592–596
Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM (2005) Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol 23:5814–5830
Eakin EG, Youlden DR, Baade PD et al (2006) Health status of long-term cancer survivors: results from an Australian population-based sample. Cancer Epidemiol Biomarkers Prev 15:1969–1976
Hewitt M, Rowland JH, Yancik R (2003) Cancer survivors in the United States: age, health and disability. J Gerontol A Biol Sci Med Sci 58:82–91
Yabroff KR, Lawrence SC, Davis WW, Brown ML (2004) Burden of illness in cancer survivors: findings from a population-based national sample. J Natl Cancer Inst 96:1322–1330
Baade PD, Fritschi L, Eakin EG (2006) Non-cancer mortality among people diagnosed with cancer. Cancer Causes Control 17:287–297
Brown BW, Brauner C, Minnotte MC (1993) Noncancer deaths in white adult cancer patients. J Natl Cancer Inst 85:979–987
Kawahara M, Ushijima S, Kamimori T et al (1998) Second primary tumours in more than 2-year disease-free survivors of small-cell lung cancer in Japan: the role of smoking cessation. Br J Cancer 78:409–412
Khuri FR, Kim ES, Lee JJ et al (2001) The impact of smoking status, disease stage, and index tumor site on second primary tumor incidence and tumor recurrence in the head and neck retinoid chemoprevention trial. Cancer Epidemiol Biomarkers Prev 10:823–829
Do KA, Johnson MM, Doherty DA et al (2003) Second primary tumors in patients with upper aerodigestive tract cancers: joint effects of smoking and alcohol (United States). Cancer Causes Control 14:131–138
Hebert JR, Hurley TG, Ma Y (1998) The effect of dietary exposures on recurrence and mortality in early stage breast cancer. Breast Cancer Res Treat 51:17–28
Rock CL, Demark-Wahnefried W (2002) Nutrition and survival after the diagnosis of breast cancer: a review of the evidence. [erratum appears in J Clin Oncol 2002 Sep;15 20(18):3939]. J Clin Oncol 20:3302–3316
Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. J Am Med Assoc 293:2479–2486
Meyerhardt JA, Giovannucci EL, Holmes MD et al (2006) Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24:3527–3534
Meyerhardt JA, 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 24:3535–3541
Oeffinger K, McCabe M (2006) Models for delivering survivorship care. J Clin Oncol 24:5117–5124
Rowland JH, Hewitt M, Ganz PA (2006) Cancer survivorship: a new challenge in delivering quality cancer care. J Clin Oncol 24:5101–5104
Pinto BM, Trunzo JJ (2005) Health behaviors during and after a cancer diagnosis. Cancer 104(11 Suppl):2614–2623
Bellizzi KM, Rowland JH, Jeffery DD, McNeel T (2005) Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol 23:8884–8893
Coups EJ, Ostroff JS (2005) A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med 40:702–711
Courneya KS (2003) Exercise in cancer survivors: an overview of research. Med Sci Sports Exerc 35:1846–1852
Davies AA, Davey Smith G, Harbord R et al (2006) Nutritional interventions and outcome in patients with cancer or preinvasive lesions: systematic review. J Natl Cancer Inst 98:961–973
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 24:5125–5131
Stevinson C, Lawlor DA, Fox KR (2004) Exercise interventions for cancer patients: systematic review of controlled trials. Cancer Causes Control 15:1035–1056
Demark-Wahnefried W (2006) Cancer survival: time to get moving? Data accumulate suggesting a link between physical activity and cancer survival. J Clin Oncol 24:3517–3518
Chlebowski RT, Blackburn GL, Thomson CA et al (2006) Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women’s Intervention Nutrition Study. J Natl Cancer Inst 98:1767–1776
Gritz ER, Carr CR, Rapkin D et al (1993) Predictors of long-term smoking cessation in head and neck cancer patients. Cancer Epidemiol Biomarkers Prev 2:261–270
Doyle C, Kushi LH, Byers T et al (2006) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA – Cancer J Clin 56:323–353
Kushi LH, Byers T, Doyle C et al (2006) American cancer society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA – Cancer J. Clin 56:254–281; quiz 313–254
Australian Institute of Health, Welfare (AIHW) (2004) Cancer in Australia 2001. AIHW Cat no CAN 23, Canberra
Australian Bureau of Statistics (2003) National health survey: user’s guide. ABS, Canberra
Queensland Cancer Registry (2004) Cancer in Queensland: incidence and mortality, 1982 to 2002. Queensland Cancer Registry, Queensland Health and Queensland Cancer Fund, Brisbane
Australian Institute of Health, Welfare (2003) The active Australia survey: a guide and manual for implementation, analysis and reporting. AIHW, Canberra
National Health, Medical Research Council (2003) Dietary guidelines for Australian adults. Commonwealth of Australia, Canberra
National Health, Medical Research Council (2001) Australian alcohol guidelines: health risk and benefits. Commonwealth of Australia, Canberra
National Health, Medical Research Council (1999) Clinical practice guidelines: the management of cutaneous melanoma. Commonwealth of Australia, Canberra
Adler NE, Ostrove JM (1999) Socioeconomic status and health: what we know and what we don’t. Ann N Y Acad Sci 896:3–15
SAS Institute Inc (2004) SAS onlinedoc, version 8. SAS Institute Cary, NC
Pinto BM, Eakin E, Maruyama NC (2000) Health behavior changes after a cancer diagnosis: what do we know and where do we go from here? Ann Behav Med 22:38–52
Montague M, Borland R, Sinclair C (2001) Slip! slop! slap! and sunsmart, 1980-2000: skin cancer control and 20 years of population-based campaigning. Health Educ Behav 28:290–305
International Agency for Research on Cancer (2004) Tobacco smoke and involuntary smoking (vol 83). IARC, Lyon, France
Giovannucci EL, Liu T, Leitzmann MF, Stampfer MJ, Willett WC (2005) A prospective study of physical activity and incident and fatal prostate cancer. Arch Intern Med 165:1005–1010
Wagner EH (2001) Meeting the needs of chronically ill people. Br Med J 323:945–946
Wagner EH, Groves T (2002) Care for chronic diseases. Br Med J 325:913–914
Bowman C, Whistler J, Ellerby M (2004) A national census of care home residents. Age Ageing 33:5661–5566
Jordhoy MS, Saltvedt I, Fayers P, Loge JH, Ahlner-Elmqvist M, Kaasa S (2003) Which cancer patients die in nursing homes? Quality of life, medical and sociodemographic characteristics. Palliat Med 17:433–444
Supported by National Health and Medical Research Council Project Grant No. 290519.
About this article
Cite this article
Eakin, E.G., Youlden, D.R., Baade, P.D. et al. Health behaviors of cancer survivors: data from an Australian population-based survey. Cancer Causes Control 18, 881–894 (2007). https://doi.org/10.1007/s10552-007-9033-5
- Health behavior