Health behaviors, quality of life, and psychosocial health among survivors of adolescent and young adult cancers
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Survivors of adolescent and young adult (AYA) cancer may engage in unhealthy lifestyles (e.g., smoking), potentially heightening their risk for long-term health problems. We assessed health behaviors and constructs including quality of life (QOL) and psychosocial well-being among survivors of AYA cancer compared to the general population.
We used 2009 Behavioral Risk Factor Surveillance System data to evaluate health behaviors for survivors of AYA cancer compared to AYAs without cancer. Multivariable regressions assessed health behaviors (smoking, binge drinking, physical inactivity, and low fruit/vegetable intake) by sex and age between AYA survivors and controls, and among survivors to determine the effects of demographic, QOL, psychosocial, and cancer factors on behaviors.
A greater proportion of female survivors of AYA cancer smoked than controls (currently aged 20–39: 27 vs. 14.3%, respectively; currently aged 40–64: 29.3 vs. 18.4%, respectively). Generally, survivors and controls were non-adherent to national health behavior guidelines. Uninsured survivors were at greater risk of smoking vs. insured (females, Relative Risk (RR) = 1.64, 95 % confidence interval (CI) 1.43–1.90; males, RR = 2.62, 95 % CI 1.71–4.02). Poor social/emotional support was associated with smoking (RR = 1.26, 95 % CI 1.07–1.48) among female survivors and was associated with low fruit/vegetable intake among male (RR = 1.12, 95 % CI 1.01–1.23) and female (RR = 1.12, 95 % CI 1.05–1.19) survivors. Female survivors >10 years from diagnosis had higher risk of smoking (RR = 1.26–1.91, all p < 0.01) than survivors 5–10 years from diagnosis.
Unhealthy lifestyle behaviors are common in survivors of AYA cancer.
Implications for Cancer Survivors
AYA survivors require health behavior support.
KeywordsQuality of life Adolescent and young adult Smoking Diet Binge drinking Exercise
- 1.Adolescent and Young Adult Oncology Progress Review Group. Closing the gap: research and care imperatives for adolescents and young adults with cancer. 2006; http://planning.cancer.gov/library/AYAO_PRG_Report_2006_FINAL.pdf. Accessed 5 June 2015.
- 2.Ries LAC, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Mariotto A et al. SEER Cancer Statistics Review, 1975–2005. National Cancer Institute, Bethesda, MD. 2008. http://seer.cancer.gov/csr/1975_2005/. Accessed 24 Sep 2014.
- 4.Maggs JL, Schulenberg J, Hurrelmann K. Developmental transitions during adolescence: health promotion implications. In: Schulenberg J, Maggs JL, Hurrelmann K, editors. Health risks and developmental transitions during adolescence. 1st ed. Cambridge: The Press Syndicate of the University of Cambridge; 1997. p. 522–46.Google Scholar
- 11.Centers for Disease Control and Prevention. Behavioral risk factor surveillance system 2009 summary data quality report. 2011; http://www.cdc.gov/brfss/annual_data/2009/pdf/2009_summary_data_quality_report.pdf. Accessed 5 June 2015.
- 15.Children’s Oncology Group. Staying healthy through diet and physical activity. Long-term follow-up guidelines for survivors of childhood, adolescent, and young adult cancers. 2008; http://www.survivorshipguidelines.org/pdf/DietandPhysicalactivity.pdf. Accessed 5 June 2015.
- 16.Centers for Disease Control and Prevention. 5 a day works! Department of Health and Human Services. 2005; http://www.cdc.gov/nccdphp/dnpa/nutrition/health_professionals/programs/5aday_works.pdf. Accessed 5 June 2015.
- 17.Centers for Disease Control and Prevention. Measuring healthy days: population assessment of health-related quality of life. 2000; http://www.cdc.gov/hrqol/pdfs/mhd.pdf. Accessed 5 June 2015.
- 19.Heeringa SG, West BT, Berglund PA. Applied survey data analysis. New York: Chapman-Hall. 2010.Google Scholar
- 21.Rabin C, Politi M. Need for health behavior interventions for young adult cancer survivors. Am J Health Behav. 2010;34(1):70–6.Google Scholar
- 22.Emmons KM, Puleo E, Park E, Gritz ER, Butterfield RM, Weeks JC, et al. Partnership for health-2, a web-based versus print smoking cessation intervention for childhood and young adult cancer survivors: randomized comparative effectiveness study. J Med Internet Res, 2013. 15(11): p. e218.Google Scholar
- 25.Kaiser Family Foundation. Preventive services covered by private health plans under the Affordable Care Act. 2014; http://kff.org/health-reform/fact-sheet/preventive-services-covered-by-private-health-plans/. Accessed 7 Nov 2014.
- 34.Blumberg S, Ganesh N, Luke J, Gonzales G. Wireless substitution: state-level estimates from the National Health Interview Survey, 2012. National Health Statistics Reports. 2013;70.Google Scholar
- 37.Underwood JM, Townsend JS, Stewart SL, Buchannan N, Ekwueme DU, Hawking NA. Surveillance of demographic characteristics and health behaviors among adult cancer survivors—behavioral risk factor surveillance system, United States, 2009. MMWR Morb Mortal Wkly Rep. 2012;61:1–23.Google Scholar