Comparison of health behaviours between cancer survivors and the general population: a cross-sectional analysis of the Lifelines cohort

Abstract

Purpose To compare the differences in lifestyle behaviours between cancer survivors (CSs) and cancer-free participants in a large and representative population-based cohort. Methods We included 115,257 adults from the Lifelines cohort. Cancer status was self-reported, and health behaviours were measured (e.g. body mass index [BMI]) or assessed by questionnaire (e.g. physical activity, smoking, alcohol consumption, sedentary behaviour and diet). The data were then categorised for logistic regression analysis, stratified and adjusted by sex and age (< 55 vs ≥ 55 years). Results CSs (5473; 4.7%) were diagnosed 9 ± 8.5 years before data collection, were older (mean age 55.4 vs 44.4 years) and more often female (66.6% vs 33.4%) than the cancer-free participants. They were also more likely to be physically active and to have a better diet, and also less likely to be alcohol drinkers; but, were more likely to have a higher BMI, be former smokers and to be sedentary. After adjustment for sex and age, however, BMI was more likely to be normal, physical activity was more likely to be higher and smoking to be prevalent in CSs. Current smoking was also significantly higher among females and those aged < 55 years who were CSs than for those with no history of cancer. Conclusions In this population-based cohort, CSs have health behaviour comparable to those without a cancer diagnosis. Implications for cancer survivors Smoking cessation strategies should target all CSs, but efforts could yield greatest benefit if they target females and those younger than 55 years.

A Classification Approach for Cancer Survivors from Those Cancer-Free, Based on Health Behaviors: Analysis of the Lifelines Cohort

“…Results obtained in this study suggested that differences among health behaviors in the Dutch Lifelines cohort were not relevant enough to make a proper classification of cancer survivors and cancer-free participants, and this may be due to the relatively homogenous distribution of such health behaviors among this population. This is in agreement with a previous approach in this cohort that used only logistic regression and did not identify substantial differences among cancer survivors and the general population [ 46 ]. However, also consistent with previous research [ 16 ], age was the dominant predictor (0.74 ± 0.01): after excluding age from the prediction, cancer survivors and participants with no history of cancer did not differ considerably by any other health behavior.…”

Physical Activity and Cancer Status Among Middle-Aged and Older Chinese: A Population-Based, Cross-Sectional Study

“…The CCHS found that respondents with cancer were more likely to be inactive than those who had never had cancer (OR = 1.39, 95% CI = 1.21-1.58 inactive vs. active) (Neil et al, 2014). However, the Lifelines cohort study conducted in a Dutch population contrasted with our study, as the Lifelines study found that cancer survivors were significantly more likely to be physically active than people without a history of cancer (Cortés-Ibáñez et al, 2020). These conflicting findings might be attributed to differences in cancer types, current treatment status, types of treatment, and cancer stages.…”

“…Model 2 was adjusted for demographic characteristics (including age, sex, marital status, education, and place of residence). Model 3 was further adjusted for health-related behaviors (smoking, drinking frequency, sleep duration, and obesity), depressive symptoms and chronic comorbidities ( Shi et al, 2017 ; Cortés-Ibáñez et al, 2020 ). We retained the covariates, even if they were not statistically significant in changing the association between PA and cancer, to see if PA was independent of these variables.…”

The impact of the COVID-19 pandemic on the health behaviours of people living with and beyond breast, prostate, and colorectal cancer—a qualitative study

“…However, beginning to uncover typology related to health behaviour orientation in people LWBC has shown that even habitual exercisers struggled at times and needed support. A pre-pandemic population-based cohort study examining differences in key health behaviours between a general population sample and people LWBC found no significant differences, suggesting a cancer diagnosis does not provoke lasting behaviour change [ 36 ]. However, the typology reported in this current study suggests that orientation to health behaviours may be substantially influenced by diagnosis experiences for some types of people LWBC.…”

“…However, the typology reported in this current study suggests that orientation to health behaviours may be substantially influenced by diagnosis experiences for some types of people LWBC. Given the importance of healthy lifestyles, strategies for effective support for behaviour change in people LWBC need to be identified, especially as enduring behaviour change is minimal in this group [ 18 , 19 , 36 ]. The typology may provide a useful starting point for the design of future interventions, which could identify and target support for people based on specific attitudes and orientation towards health behaviours, rather than demographic or clinical characteristics.…”