Lifestyle behaviours of young adult survivors of childhood cancer

Abstract

This cross-sectional study collected baseline data on the health behaviours of a large population of survivors of childhood cancer in the UK, aged 18 -30 years, compared with those of sex-and age-matched controls. Data from 178 young adult survivors of childhood cancer, diagnosed and treated at Bristol Children's Hospital, 184 peers from the survivors' GP practices and 67 siblings were collected by postal questionnaire. Conditional logistic regression analysis showed that, for matched sets of survivors and controls, survivors of a variety of childhood cancers reported lower levels of alcohol consumption (P=0.005), lower levels of cigarette smoking (P=0.027) and lower levels of recreational drug use (P=0.001) than controls. Analysis of matched sets of survivors and siblings showed similar trends but no significant differences. A health behaviour index for each participant was constructed from the data collected on five key health behaviours which influence future health status. Comparison of the means for each case group showed that survivors of childhood cancer were leading healthier lives than controls or siblings. This finding was expressed most clearly as the difference in the means of the health behaviour index for each case group, derived from five health behaviours (one-way ANOVA, P50.001). British Journal of Cancer (2002) It is only in the last 30 years that advances in the treatment of childhood cancer have resulted in the majority of patients surviving into adulthood, with the probability of being able to live a normal life-span. Recent research (Coleman et al, 1999, cited in CRC, 1999 shows that several childhood cancers now have survival rates in excess of 75%. However, an increased risk of early death from causes other than the original cancer for survivors, when compared with their siblings, has been found (Nicholson et al, 1994). There is also considerable evidence to show that survivors of childhood cancer are at increased risk of developing other late-effects including a second cancer. These may be due to a combination of genetic factors (Li et al, 1988) and/or the consequences of damage to various organs caused by the original treatment (Hawkins and Stevens, 1996).It is well known that lifestyle factors, including smoking, consumption of alcohol, diet, sexual and sun behaviour, influence the risk of developing cancers and other health conditions in the general population. Since survivors of childhood cancer have been shown to be a population susceptible to further ill-health, it is likely that non-avoidance of known 'risk' health behaviours by this vulnerable population of young people may further increase this risk. Until recently, little research has been carried out on lifestyles of survivors, but with increasing numbers reaching adulthood their adjustment and assimilation into the community and their health behaviours have become a focus for research. Do the health behaviours and lifestyles of survivors of childhood cancer differ from those of their peers, and if so, how? No British data i...

Barriers and Facilitators of Healthy Diet and Exercise Among Adolescent and Young Adult Cancer Survivors: Implications for Behavioral Interventions

“…Findings in the literature are mixed as to whether AYA survivors' engagement in health behaviors is worse or better than that of their healthy peers. 37,38 However, for AYA survivors with suboptimal adherence to recommended health behaviors, supportive care services could be tailored to their needs and address their unique challenges and barriers to accessing such services (e.g., time limitations due to raising young children, financial challenges after cancer treatment, and starting one's career). [39][40][41][42] The current study of AYA cancer survivors and their supporters identified a number of barriers to and facilitators of healthy lifestyle behaviors that could be useful when designing AYA-specific health interventions.…”

Assessment of cardiometabolic risk factors among adolescent survivors of childhood cancer

“…11 Having received highly toxic cardiopulmonary therapy does not appear to modify smoking prevalence. 13 Alcohol use was higher than tobacco use in both groups. No significant differences were found in alcohol or tobacco use by group or age; however, differences were significant by age.…”

“…In spite of being a vulnerable population, these survivors display risky behaviors similar to the general population. Although tobacco and alcohol use is generally lower than in the general population, [12][13][14][15]21 there are subsets who frequently abuse alcohol. 14,[22][23][24] Pediatricians are in an exceptional position to promote healthy habits and perform periodic check-ups for an early screening of cardiometabolic complications among ASCC.…”

“…5,6 These events, together with an inactive lifestyle 9,10 and tobacco use, 11 are secondary to cancer treatment c o m p l i c a t i o n s ( a n t h r a c y c l i n e chemotherapy regimen, 7 thoracic and cranial radiotherapy). 8,9 Although cancer survivors have a higher risk for late cardiometabolic events, they are mostly sedentary, frequently use tobacco and alcohol, [12][13][14] even since adolescence, 15 and do not attend periodic medical check-ups. 16 In Argentina, the annual incidence of childhood cancer is 124/1 000 000 in children younger than 15 years old, with an average survival of 65%.…”

Evaluación de factores de riesgo cardio metabólicoen adolescentes sobrevivientes de cáncer infantil

“…Pese al mayor riesgo de eventos tardíos cardíacos y metabólicos, los sobrevivientes de cáncer son, en su mayoría, sedentarios, consumen frecuentemente tabaco y alcohol, [12][13][14] incluso desde la adolescencia, 15 y no realizan controles médicos regulares. 16 En Argentina, la tasa de incidencia a n u a l d e c á n c e r i n f a n t i l e s d e 124/1 000 000 en menores de 15 años, con un promedio de supervivencia del 65%.…”