Journal of Cancer Survivorship

, Volume 10, Issue 4, pp 692–698 | Cite as

Lifestyle behaviors among US cancer survivors

  • Dana S. MowlsEmail author
  • Lacy S. Brame
  • Sydney A. Martinez
  • Laura A. Beebe



We describe and compare lifestyle behaviors, including smoking, physical activity, alcohol consumption, and nutrition, among cancer survivors to individuals with no cancer.


Data from the 2013 Behavior Risk Factor Surveillance System were used for this cross-sectional study. Weighted analysis was performed, and associations were examined by adjusted prevalence ratios (APRs) and 95 % confidence intervals (CIs).


Comparing survivors to individuals with no cancer history, differences were found for a smoking quit attempt (APR 1.08; CI 1.04, 1.12), physical inactivity (APR 1.11; CI 1.07, 1.15), and binge drinking (APR 0.89; CI 0.83, 0.95). An interaction with gender was observed when examining smoking and heavy drinking. Smoking was lower (APR 0.85; CI 0.79, 0.92) among male survivors than males with no cancer history, while higher (APR 1.25; CI 1.18, 1.32) among female survivors compared to females with no cancer history. Heavy drinking (APR 0.85; CI 0.73, 0.98) was lower among male survivors than males with no cancer history, while cancer survivorship was not associated with heavy drinking among females. No differences existed for fruit and vegetable consumption or body mass index.


US cancer survivors are not more likely than the general population to engage in all healthy lifestyle behaviors. Interventions, including improved physician communication, to reduce physical inactivity among all cancer survivors and cigarette smoking among female survivors are needed.

Implications for Cancer Survivors

Cancer survivors are at increased risk for comorbid conditions, and acceptance of healthy behaviors may reduce dysfunction and improve long-term health. Ultimately, opportunities exist for clinicians to promote lifestyle changes that may improve the length and quality of life of their patients.


Cancer Survivors Gender Lifestyle behaviors Smoking Obesity 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Winer E, Gralow J, Diller L, Karlan B, Loehrer P, Pierce L, et al. Clinical cancer advances 2008: major research advances in cancer treatment, prevention, and screening—a report from the American Society of Clinical Oncology. J Clin Oncol. 2009;27(5):812–26.CrossRefPubMedGoogle Scholar
  2. 2.
    Centers for Disease Control and Prevention, Division of Cancer Prevention and Control. Cancer prevention and control: basic information about cancer survivorship. 2014. Accessed May 2015.
  3. 3.
    Edwards BK, Howe HL, Ries LA, Thun MJ, Rosenberg HM, Yancik R, et al. Annual report to the nation on the status of cancer, 1973-1999, featuring implications of age and aging on U.S. cancer burden. Cancer. 2002;94(10):2766–92.CrossRefPubMedGoogle Scholar
  4. 4.
    McBride CM, Clipp E, Peterson BL, Lipkus IM, Demark-Wahnefried W. Psychological impact of diagnosis and risk reduction among cancer survivors. Psycho-Oncology. 2000;9(5):418–27.CrossRefPubMedGoogle Scholar
  5. 5.
    Blanchard CM, Stein KD, Baker F, Dent MF, Denniston MM, Courneya KS, et al. Association between current lifestyle behaviors and health-related quality of life in breast, colorectal, and prostate cancer survivors. Psychol Health. 2004;19(1):1–13.CrossRefGoogle Scholar
  6. 6.
    Parsons A, Daley A, Begh R, Aveyard P. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. 2010.Google Scholar
  7. 7.
    Lee J, Meyerhardt JA, Giovannucci E, Jeon JY. Association between body mass index and prognosis of colorectal cancer: a meta-analysis of prospective cohort studies. PLoS One. 2015;10(3):e0120706.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Centers for Disease Control and Prevention. Cancer survivors—United States, 2007. MMWR Morb Mortal Wkly Rep. 2011;60:269–72.Google Scholar
  9. 9.
    Rock CL, Doyle C, Demark‐Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA: Cancer J Clin. 2012;62(4):242–74.Google Scholar
  10. 10.
    Network NCC. NCCN publishes new guidelines for smoking cessation 2015. Accessed June 21 2015.
  11. 11.
    Underwood JM, Townsend JS, Stewart SL, Buchannan N, Ekwueme DU, Hawkins NA et al. Surveillance of demographic characteristics and health behaviors among adult cancer survivors: Behavioral Risk Factor Surveillance System, United States, 2009. 2012.Google Scholar
  12. 12.
    Centers for Disease Control and Prevention. OVERVIEW: BRFSS 2013.
  13. 13.
    Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System, 2013 Summary Data Quality Report. 2014. Scholar
  14. 14.
    Doyle C, Kushi LH, Byers T, Courneya KS, Demark-Wahnefried W, Grant B, et al. Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA: Cancer J Clin. 2006;56(6):323–53.Google Scholar
  15. 15.
    Bonnet F, Irving K, Terra J-L, Nony P, Berthezène F, Moulin P. Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis. 2005;178(2):339–44.CrossRefPubMedGoogle Scholar
  16. 16.
    Menon U, Kreps GL, McCance K. Health behaviors in cancer survivors. Oncol Nurs Forum. 2007;34(3):643.CrossRefPubMedGoogle Scholar
  17. 17.
    Bellizzi KM, Rowland JH, Jeffery DD, McNeel T. Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol. 2005;23(34):8884–93.CrossRefPubMedGoogle Scholar
  18. 18.
    Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol Ser A Biol Med Sci. 2003;58(1):82–91.CrossRefGoogle Scholar
  19. 19.
    Centers for Disease Control and Prevention. Surveillance of demographic characteristics and health behaviors among adult cancer survivors: Behavioral Risk Factor Surveillance System, United States, 2009. MMWR 2012;61(1).Google Scholar
  20. 20.
    Network NCC. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): smoking cessation 2015.Google Scholar
  21. 21.
    US Department of Health Human Services. The health consequences of smoking—50 years of progress. A report of the Surgeon General. 2014.Google Scholar
  22. 22.
    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. doi: 10.1249/MSS.0b013e3181e0c112.CrossRefPubMedGoogle Scholar
  23. 23.
    Edwards BK, Noone AM, Mariotto AB, Simard EP, Boscoe FP, Henley SJ, et al. Annual report to the nation on the status of cancer, 1975‐2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer. Cancer. 2014;120(9):1290–314.CrossRefPubMedGoogle Scholar
  24. 24.
    Leach CR, Weaver KE, Aziz NM, Alfano CM, Bellizzi KM, Kent EE, et al. The complex health profile of long-term cancer survivors: prevalence and predictors of comorbid conditions. J Cancer Survivorship. 2014;9(2):239–51.CrossRefGoogle Scholar
  25. 25.
    United States Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. DIANE Publishing; 1996.Google Scholar
  26. 26.
    Network NCC. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Survivorship 2015. 2015.Google Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Dana S. Mowls
    • 1
    Email author
  • Lacy S. Brame
    • 1
  • Sydney A. Martinez
    • 1
  • Laura A. Beebe
    • 1
  1. 1.Department of Biostatistics and Epidemiology, College of Public HealthUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA

Personalised recommendations