1
|
Gavioli C, Vlooswijk C, Janssen SHM, Kaal SEJ, Kerst JM, Tromp JM, Bos MEMM, van der Hulle T, van der Graaf WTA, Lalisang RI, Nuver J, Bijlsma RM, Kouwenhoven MCM, Husson O, Beijer S. Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention in adolescent and young adult (AYA) cancer survivors: results from the SURVAYA study. J Cancer Surviv 2024:10.1007/s11764-023-01529-4. [PMID: 38224397 DOI: 10.1007/s11764-023-01529-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE For adolescent and young adult (AYA) cancer survivors with a good prognosis, having a healthy lifestyle prevents morbidity and mortality after treatment. The aim of this study was to investigate the prevalence of (un)healthy lifestyle behaviors and related determinants in AYA cancer survivors. METHODS A population-based, cross-sectional study was performed among long-term (5-20 years) AYA cancer survivors (18-39 years old at diagnosis) registered within the Netherlands Cancer Registry. Self-reported questionnaires data about health behaviors were used to calculate the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) adherence score. Associations between the score and clinical/sociodemographic determinants of (un)healthy behaviors were investigated using logistic regression models. RESULTS The mean WCRF/AICR score was low to moderate, 3.8 ± 1.2 (0.5-7.0) (n = 3668). Sixty-one percent adhered to "limit the consumption of sugar sweetened drinks," 28% to "be a healthy weight," 25% to "fruit and vegetable consumption," and 31% to "limit alcohol consumption." Moderate and high adherence were associated with being a woman (ORmoderate = 1.46, 95% CI = 1.14-1.85, and ORhigh = 1.87, 95% CI = 1.46-2.4) and highly educated (ORmoderate = 1.54, 95% CI = 1.30-1.83, and ORhigh = 1.87, 95% CI = 1.46-2.4). Low adherence was associated with smoking (ORmoderate = 0.68, 95% CI = 0.50-0.92, and ORhigh = 0.30, 95% CI = 0.21-0.44) and diagnosis of germ cell tumor (ORmoderate = 0.58, 95% CI = 0.39-0.86, and ORhigh = 0.45, 95% CI = 0.30-0.69). CONCLUSIONS Adherence to the 2018 WCRF/AICR lifestyle recommendations was low to moderate, especially regarding body weight, fruit, vegetables, and alcohol consumption. Men, current smokers, lower-educated participants, and/or those diagnosed with germ cell tumors were less likely to have a healthy lifestyle. IMPLICATIONS FOR CANCER SURVIVORS Health-promotion programs (e.g., age-specific tools) are needed, focusing on high-risk groups.
Collapse
Affiliation(s)
- Costanza Gavioli
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, 3511 DT, Utrecht, The Netherlands
| | - Carla Vlooswijk
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, 3511 DT, Utrecht, The Netherlands
| | - Silvie H M Janssen
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
| | - Suzanne E J Kaal
- Department of Medical Oncology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - J Martijn Kerst
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
| | - Jacqueline M Tromp
- Department of Medical Oncology, Amsterdam University Medical Center, 1105 AZ, Amsterdam, The Netherlands
| | - Monique E M M Bos
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD, Rotterdam, The Netherlands
| | - Tom van der Hulle
- Department of Medical Oncology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD, Rotterdam, The Netherlands
| | - Roy I Lalisang
- Department of Internal Medicine, GROW-School of Oncology and Reproduction, Maastricht UMC+ Comprehensive Cancer Center, 6229 HX, Maastricht, The Netherlands
| | - Janine Nuver
- Department of Medical Oncology, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Rhodé M Bijlsma
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
| | - Mathilde C M Kouwenhoven
- Department of Neurology, Amsterdam UMC, Amsterdam University Medical Centers, Location VUmc, 1081 HV, Amsterdam, The Netherlands
| | - Olga Husson
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands.
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands.
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD, Rotterdam, The Netherlands.
| | - Sandra Beijer
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, 3511 DT, Utrecht, The Netherlands
| |
Collapse
|
2
|
Brackmann LK, Foraita R, Schwarz H, Galetzka D, Zahnreich S, Hankeln T, Löbrich M, Poplawski A, Grabow D, Blettner M, Schmidberger H, Marron M. Late health effects and changes in lifestyle factors after cancer in childhood with and without subsequent second primary cancers – the KiKme case-control study. Front Oncol 2022; 12:1037276. [PMID: 36324589 PMCID: PMC9618813 DOI: 10.3389/fonc.2022.1037276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/26/2022] [Indexed: 11/30/2022] Open
Abstract
Background Improved treatments for childhood cancer result in a growing number of long-term childhood cancer survivors (CCS). The diagnosis and the prevalence of comorbidities may, however, influence their lifestyle later in life. Nonetheless, little is known about differences in late effects between CCS of a first primary neoplasm (FPN) in childhood and subsequent second primary neoplasms (SPN) and their impact on lifestyle. Therefore, we aim to investigate associations between the occurrence of FPN or SPN and various diseases and lifestyle in the later life of CCS. Methods CCS of SPN (n=101) or FPN (n=340) and cancer-free controls (n=150) were matched by age and sex, and CCS additionally by year and entity of FPN. All participants completed a self-administered questionnaire on anthropometric and socio-economic factors, medical history, health status, and lifestyle. Mean time between FPN diagnosis and interview was 27.3 years for SPN and 26.2 years for FPN CCS. To confirm results from others and to generate new hypotheses on late effects of childhood cancer as well as CCS´ lifestyles, generalized linear mixed models were applied. Results CCS were found to suffer more likely from diseases compared to cancer-free controls. In detail, associations with cancer status were observed for hypercholesterinemia and thyroid diseases. Moreover, CCS were more likely to take regular medication compared to controls. A similar association was observed for CCS of SPN compared to CCS of FPN. In contrast to controls, CCS rarely exercise more than 5 hours per week, consumed fewer soft and alcoholic drinks, and were less likely to be current, former, or passive smokers. Additionally, they were less likely overweight or obese. All other exploratory analyses performed on cardiovascular, chronic lung, inflammatory bone, allergic, and infectious diseases, as well as on a calculated health-score revealed no association with tumor status. Conclusion CCS were more affected by pathologic conditions and may consequently take more medication, particularly among CCS of SPN. The observed higher disease burden is likely related to the received cancer therapy. To reduce the burden of long-term adverse health effects in CCS, improving cancer therapies should therefore be in focus of research in this area.
Collapse
Affiliation(s)
- Lara Kim Brackmann
- Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
- Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Ronja Foraita
- Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Heike Schwarz
- Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Danuta Galetzka
- Department of Radiation Oncology and Radiation Therapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Sebastian Zahnreich
- Department of Radiation Oncology and Radiation Therapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Thomas Hankeln
- Institute of Organismic and Molecular Evolution, Molecular Genetics and Genome Analysis, Johannes Gutenberg University, Mainz, Germany
| | - Markus Löbrich
- Radiation Biology and deoxyribonucleic acid (DNA) Repair, Technical University of Darmstadt, Darmstadt, Germany
| | - Alicia Poplawski
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Desiree Grabow
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Heinz Schmidberger
- Department of Radiation Oncology and Radiation Therapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Manuela Marron
- Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
- *Correspondence: Manuela Marron,
| |
Collapse
|
3
|
Chardon ML, Beal SJ, Breen G, McGrady ME. Systematic Review of Substance Use Measurement Tools in Adolescent and Young Adult Childhood Cancer Survivors. J Adolesc Young Adult Oncol 2021; 11:333-345. [PMID: 34550793 PMCID: PMC9464089 DOI: 10.1089/jayao.2021.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Substance use among adolescents and young adults (AYAs) is associated with an increased risk of poor physical and mental health outcomes. For AYA childhood cancer survivors (CCSs), substance use may also increase their likelihood of experiencing late effects. As a result, professional organizations recommend that AYA CCSs be regularly screened for risk behaviors, including substance use. The best methods for assessing these behaviors as part of clinical care for AYA CCSs, however, remain unclear. To begin to address this gap, the purpose of this study was to systematically review written substance use measures that have been used with AYA CCSs and published between 2000 and 2020. A search of PubMed, PsycINFO, and CINAHL using terms related to substance use and AYA CCSs identified 47 articles representing 20 different written substance use measures that evaluated current substance use (i.e., use of alcohol, tobacco, marijuana, prescription medications taken in a manner other than as prescribed, and/or other illicit substances within the 12 months). Measures varied in domains assessed, item formats, and response formats. Results are presented alongside recommendations for selecting screening tools for use with AYA CCS populations in both clinical and research settings.
Collapse
Affiliation(s)
- Marie L Chardon
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Sarah J Beal
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Gabriella Breen
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Meghan E McGrady
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| |
Collapse
|
4
|
Bougas N, Fresneau B, Pinto S, Mayet A, Marchi J, Pein F, Mansouri I, Journy NMY, Jackson A, Souchard V, Demoor-Goldschmidt C, Vu-Bezin G, Rubino C, Oberlin O, Haddy N, de Vathaire F, Allodji RS, Dumas A. Smoking and Cannabis Use among Childhood Cancer Survivors: Results of the French Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev 2021; 30:1965-1973. [PMID: 34321283 DOI: 10.1158/1055-9965.epi-21-0193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/15/2021] [Accepted: 07/21/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Unhealthy behaviors among childhood cancer survivors increase the risks for cancer treatment adverse effects. We aimed to assess tobacco and cannabis use prevalence in this population and to identify factors associated with these consumptions. METHODS This study involved 2,887 5-year survivors from the French childhood cancer survivor study (FCCSS) cohort. Data on health behaviors were compared with those of controls from the general population. Associations of current smoking and cannabis use with clinical features, sociodemographic characteristics, and health-related quality of life (QOL) were investigated using multivariable logistic regressions. RESULTS Prevalence for tobacco use was lower in survivors (26%) than in controls (41%, P < 0.001). Among current smokers, survivors smoked more cigarettes per day and started at a younger age than controls. Women, college graduates, older, married, and CNS tumor survivors, as well as those who received chemotherapy and thoracic radiation therapy, were less likely to be smokers and/or cannabis consumers than others. Participants with a poor mental QOL were more likely to smoke. CONCLUSIONS Preventive interventions and cessation programs must be carried out as early as possible in survivors' life, especially among young males with low educational level and poor mental health. IMPACT This study brings new insights to health behaviors among childhood cancer survivors from a population with high rates of smoking and cannabis use.
Collapse
Affiliation(s)
- Nicolas Bougas
- Université de Paris, ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research), Paris, France.,Gustave Roussy, Department of Clinical Research, Villejuif, France
| | - Brice Fresneau
- Gustave Roussy, Department of Pediatric Oncology, Villejuif, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France.,INSERM Radiation Epidemiology Team, Villejuif, France
| | - Sandrine Pinto
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Aurélie Mayet
- French Military Health Service (SSA), Center for Epidemiology and Public Health of the French Army (CESPA), Camp de Sainte Marthe, Marseille, France.,Aix-Marseille Université, INSERM, IRD, SESSTIM (Sciences économiques & sociales de la santé & traitement de l'information médicale), Marseille, France
| | - Joffrey Marchi
- French Military Health Service (SSA), Center for Epidemiology and Public Health of the French Army (CESPA), Camp de Sainte Marthe, Marseille, France
| | - François Pein
- Institut de Cancérologie de l'Ouest, site René Gauducheau CLCC Nantes-Atlantique, Département de Recherche, Saint-Herblain, France
| | - Imene Mansouri
- Gustave Roussy, Department of Clinical Research, Villejuif, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France.,INSERM Radiation Epidemiology Team, Villejuif, France
| | - Neige M Y Journy
- Gustave Roussy, Department of Clinical Research, Villejuif, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France.,INSERM Radiation Epidemiology Team, Villejuif, France
| | - Angela Jackson
- Gustave Roussy, Department of Clinical Research, Villejuif, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France.,INSERM Radiation Epidemiology Team, Villejuif, France
| | - Vincent Souchard
- Gustave Roussy, Department of Clinical Research, Villejuif, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France.,INSERM Radiation Epidemiology Team, Villejuif, France
| | - Charlotte Demoor-Goldschmidt
- Gustave Roussy, Department of Clinical Research, Villejuif, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France.,INSERM Radiation Epidemiology Team, Villejuif, France.,CHU d'Angers, Pediatric Oncology Department, Angers, France
| | - Giao Vu-Bezin
- Gustave Roussy, Department of Clinical Research, Villejuif, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France.,INSERM Radiation Epidemiology Team, Villejuif, France
| | - Carole Rubino
- Gustave Roussy, Department of Clinical Research, Villejuif, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France.,INSERM Radiation Epidemiology Team, Villejuif, France
| | - Odile Oberlin
- Gustave Roussy, Department of Pediatric Oncology, Villejuif, France
| | - Nadia Haddy
- Gustave Roussy, Department of Clinical Research, Villejuif, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France.,INSERM Radiation Epidemiology Team, Villejuif, France
| | - Florent de Vathaire
- Gustave Roussy, Department of Clinical Research, Villejuif, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France.,INSERM Radiation Epidemiology Team, Villejuif, France
| | - Rodrigue S Allodji
- Gustave Roussy, Department of Clinical Research, Villejuif, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France.,INSERM Radiation Epidemiology Team, Villejuif, France
| | - Agnès Dumas
- Université de Paris, ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research), Paris, France.
| |
Collapse
|
5
|
Levitt EE, Amlung MT, Gonzalez A, Oshri A, MacKillop J. Consistent evidence of indirect effects of impulsive delay discounting and negative urgency between childhood adversity and adult substance use in two samples. Psychopharmacology (Berl) 2021; 238:2011-2020. [PMID: 33782722 DOI: 10.1007/s00213-021-05827-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 03/15/2021] [Indexed: 01/13/2023]
Abstract
RATIONALE Exposure to adverse life experiences (ACEs) is robustly associated with problematic alcohol and other drug use. In addition, both ACEs and substance use have been independently associated with impulsivity. OBJECTIVE To examine whether impulsivity is implicated in the link between ACE and adult substance use in two samples. METHODS The primary sample was a cohort of community adults (N = 1431) who completed a one-time in-person assessment. A second sample was crowdsourced using Amazon Mechanical Turk (N = 3021). All participants were assessed for ACEs using the Adverse Childhood Experience Questionnaire and for current alcohol and other drug use. Given its multidimensional nature, impulsivity was assessed using the UPPS-P measure of impulsive personality traits, Go/NoGo (GNG) task (in-person community adult sample only), and delay discounting (Monetary Choice Questionnaire [MCQ] in the community adults and Effective Delay-50 [ED50] in the crowdsourced sample. Structural equation modeling was used to examine the hypothesized indirect effects for the measures of impulsivity between ACEs and substance use. RESULTS In the community adults, significant indirect effects were observed from ACEs to substance use via UPPS-Negative Urgency (β = 0.07, SE = 0.02, 95% CI [0.04, 0.10]), and the MCQ (β = 0.02 SE = .01, 95% CI [0.01, 0.03]). In the crowdsourced sample, significant indirect effects were observed from ACEs to substance use via UPPS-Negative Urgency (β = 0.05, SE = .01, 95% CI [0.04, 0.07]), UPPS-Premeditation (β = 0.04, SE = .01, 95% CI [0.02, 0.05), and the ED50 (β = 0.02, SE = .01; 95% CI [0.01, 0.03]). CONCLUSION These findings provide consistent evidence that decrements in regulation of negative emotions and overvaluation of immediate rewards indirectly link ACE and substance use. These robust cross-sectional findings support the need for elucidating the underlying neural substrates implicated and for longitudinal evaluations.
Collapse
Affiliation(s)
- E E Levitt
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3P2, Canada
- Homewood Research Institute, Guelph, ON, Canada
| | - M T Amlung
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3P2, Canada
| | - A Gonzalez
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - A Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - J MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3P2, Canada.
- Homewood Research Institute, Guelph, ON, Canada.
| |
Collapse
|
6
|
Additional medical costs of chronic conditions among adolescent and young adult cancer survivors. J Cancer Surviv 2021; 16:487-496. [PMID: 33899161 DOI: 10.1007/s11764-021-01044-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/13/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE Adolescent and young adult (AYA) cancer survivors are more likely to have multiple chronic conditions compared to AYAs without history of cancer. The financial hardship of chronic conditions associated with cancer can substantially impact cancer survivors. We aim to assess health risk behaviors and health care access factors associated with increased medical expenses in AYA cancer survivors. METHODS We utilized 2011-2016 Medical Expenditure Panel Survey (MEPS) data to identify the prevalence of chronic conditions, health risk behaviors, and health care access in 2326 AYA cancer survivors. The association between health risk behaviors, health care access factors, and chronic conditions with medical expenditures was assessed using multivariable regression with gamma distribution and log link. Analyses were adjusted for age, sex, race/ethnicity, education, and marital status. Expenses were adjusted for inflation to 2016 dollars. RESULTS Most AYA cancer survivors had ≥1 chronic condition (74%) and were diagnosed with cancer ≥10 years prior to the survey (76%). AYA cancer survivors with chronic conditions spent an additional $2777 (95% CI, $480 to $5958) annually compared to survivors with no chronic conditions. Additional annual expenses also were associated with physical inactivity ($3558; 95% CI, $2200 to $4606) and being unable to get care when needed ($1291; 95% CI, $198 to 3335). CONCLUSIONS Chronic conditions are associated with a substantial increase in medical expenses well after cancer diagnosis in AYA cancer survivors. IMPLICATION FOR CANCER SURVIVORS Getting care when needed and adopting healthy behaviors, particularly exercise, may reduce medical expenses associated with chronic conditions in AYAs.
Collapse
|
7
|
Deleemans JM, Zwicker HM, Reynolds KA, Schulte FSM. Associations Among Health Behaviors and Psychosocial Outcomes in Adolescent and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2021; 10:675-681. [PMID: 33769903 DOI: 10.1089/jayao.2020.0224] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Adolescents and young adults (AYA) experience challenges both during and after their cancer treatment. Health behaviors are important contributors to health, yet little research examines health behaviors in AYA cancer survivors. We examined frequencies of health behaviors and associations between health behaviors, psychosocial, and clinical factors in AYA cancer survivors. Methods: Participants were survivors of AYA cancer (n = 60; 38.3% male; mean age = 25.3 years [standard deviation, SD = 4.6]; mean years since therapy completion = 9.0 [SD = 4.2]) from the Alberta Children's Hospital (ACH). Survivors were 13-21 years old at the time of diagnosis. Measures included demographic and clinical data, and the ACH Long-Term Survivor's Questionnaire. Health behaviors were compared with a control group (n = 600) using data from the 2017 Canadian Community Health Survey. Frequencies, conditional logistic regression, and logistic regression analyses were conducted. Results: Compared with controls, survivors reported engaging in physical activity (91.5% vs. 87.5%; odds ratio [OR] = 0.87, 95% confidence interval [CI] = 0.34-2.24; p = 0.77), smoking tobacco (15.3% vs. 19.7%; OR = 1.85, 95% CI = 0.89-3.85; p = 0.10), and street drug use (27.6% vs. 36.5%; OR = 1.60, 95% CI = 0.88-2.91; p = 0.12) at the same rate. Survivors reported binge drinking significantly less (61.0% vs. 76.6%; OR = 0.53, 95% CI = 0.30-0.92; p = 0.024) than controls. Logistic regression analyses revealed a significant model predicting binge drinking [χ2(5, 58) = 23.17, p < 0.001] with greater time off treatment, fear of another health condition, and higher mean body mass index emerging as significant predictors. Conclusion: AYA cancer survivors engage in risky health behaviors at rates similar to their peers. Further research is needed to understand factors mediating survivors' decision to participate in risky health behaviors.
Collapse
Affiliation(s)
- Julie M Deleemans
- Department of Medical Science, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Hailey M Zwicker
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Kathleen A Reynolds
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, Canada
| | - Fiona S M Schulte
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, Canada
| |
Collapse
|
8
|
Huang YJ, Lee SL, Wu LM. Health-Promoting Lifestyle and Its Predictors in Adolescent Survivors of Childhood Cancer. J Pediatr Oncol Nurs 2021; 38:233-241. [PMID: 33595358 DOI: 10.1177/1043454221992322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Cancer survivors are at increased risk of long-term adverse effects related to the disease or treatment. Thus, it is important for cancer survivors to adopt a health-promoting lifestyle (HPL). This study aims to: (1) describe health behavior self-efficacy (HBSE) and HPL of adolescent survivors of childhood cancer, (2) examine the relationships between HBSE, HPL, and various demographic factors, and (3) identify determinants of HPL among adolescent survivors of childhood cancer. Method: A descriptive cross-sectional study was conducted with adolescent survivors of childhood cancer, ranged in age from 11 to 19 years (n = 82). Participants were recruited from pediatric oncology follow-up clinics at two medical centers in southern Taiwan. Data for each participant were collected from questionnaires assessing HBSE and HPL. Results: Only 61% of the adolescent survivors were considered as normal weight. The exercise was the lowest scoring HBSE subscale. Factors associated with better HPL included: education level, HBSE, well-being, and a healthy diet. Specifically, survivors diagnosed with cancer during adolescence exhibited significantly greater self-efficacy with stress management (F = 3.20, p = .04) compared with those diagnosed at pre-school ages. HBSE scores for well-being and a healthy diet were significant predictors of HPL, accounting for 43.8% of the total variance observed. Discussion: Our findings suggest that the age of diagnosis of childhood cancer significantly modulates the frequency of health-promoting behaviors of adolescent survivors. Thus, interventions designed to enhance adolescents' well-being and the management of a healthy diet may enhance HPL in survivors of childhood cancer.
Collapse
Affiliation(s)
- Yi-Jung Huang
- Kaohsiung Municipal Sinsing Senior High School, Kaohsiung City, Taiwan (R.O.C.)
| | - Shu-Li Lee
- School of Nursing, 38023Kaohsiung Medical University, Kaohsiung City, Taiwan (R.O.C.)
| | - Li-Min Wu
- School of Nursing, 38023Kaohsiung Medical University, Kaohsiung City, Taiwan (R.O.C.).,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan (R.O.C.)
| |
Collapse
|
9
|
Azagba S, Shan L, Manzione L. Cigarette, E-cigarette, Alcohol, and Marijuana Use by Cancer Diagnosis Status: A Longitudinal Analysis. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2021; 14:1178221820980470. [PMID: 33424226 PMCID: PMC7756047 DOI: 10.1177/1178221820980470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 11/19/2020] [Indexed: 11/26/2022]
Abstract
Background: Cancer is the second leading cause of death in the United States. Lifestyle choices such as substance abuse can impact a survivor’s health and overall quality of life. Methods: We used longitudinal data from the Wave 1-3 Population Assessment of Tobacco and Health data to examine sociodemographic characteristics and substance use behaviors (current cigarette, e-cigarette, alcohol, and marijuana use) by cancer diagnosis status. A generalized estimating equation model was used to examine the population-averaged effects of sociodemographic factors on substance use. Results: Among 1527 participants diagnosed with cancer, 14.5% used cigarettes, 3.8% used e-cigarettes, 49.1% used alcohol, and 4.2% used marijuana in the prior 30 days in Wave 1. While the prevalence of cigarette use among those with no cancer history decreased significantly between Wave 1 (21.9%) and Wave 3 (20.2%), it increased significantly among participants diagnosed with cancer from 14.5% to 16.0%. E-cigarette use decreased for both groups, whereas alcohol and marijuana use increased. Results showed that substance use among people diagnosed with cancer significantly varied by sociodemographic characteristics. Age, sex, race-ethnicity, education, income, and region of residence were significantly associated with substance use among patients diagnosed with cancer. Conclusion: Overall, substance use is lower among participants diagnosed with cancer than those with no cancer history. Substance use varies by sociodemographic characteristics among people diagnosed with cancer. More focus on substance use prevention among patients diagnosed with cancer could be beneficial in terms of improving the overall well-being of this population.
Collapse
Affiliation(s)
- Sunday Azagba
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Lingpeng Shan
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Lauren Manzione
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| |
Collapse
|
10
|
Chan CWH, Choi KC, Chien WT, Sit JWH, Wong R, Cheng KKF, Li CK, Yuen HL, Li CK. Health Behaviors of Chinese Childhood Cancer Survivors: A Comparison Study with Their Siblings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176136. [PMID: 32846965 PMCID: PMC7503484 DOI: 10.3390/ijerph17176136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 11/16/2022]
Abstract
Purpose: This study aimed to compare health behaviors between the childhood cancer survivors (CCS) and their sibling controls and to examine the pattern of health behaviors of the Hong Kong Chinese CCS and its associations with their health-related quality of life and psychological distress. Methods: A cross-sectional telephone survey was conducted. A total of 614 CCS and 208 sibling controls participated in this study. Patterns of health behaviors including lifestyle behaviors, cancer screening practices, and insurance coverage were compared. Multivariate regression analyses were performed for examining factors associated with health behaviors in CCS. Results: CCS had less alcohol consumption when compared with their sibling controls (adjusted odds ratio (AOR) = 0.65, p = 0.035). The sibling controls were more likely to have cancer screening practices (AOR = 0.38, p = 0.005) and health (AOR = 0.27, p < 0.001) and life insurance coverage (AOR = 0.38, p < 0.001). Among the CCS, those who were male, having a job or higher education, shorter time since diagnosis, and type of cancer suffered were significantly associated with alcohol consumption. Those CCS who were drinkers indicated poorer mental health (p = 0.004) and more psychological distress. Female CCS undertaking cancer screening were more likely to be employed, married/cohabiting, and have received intensive cancer treatment. Conclusion: This study reveals that Chinese childhood cancer survivors are less likely to engage in unhealthy lifestyle behaviors, insurance coverage and cancer screening, when compared with their siblings. Implications for Cancer Survivors: It is crucial for healthcare professionals to identify strategies or target interventions for raising CCS's awareness of their cancer risks and healthy lifestyle throughout their life.
Collapse
Affiliation(s)
- Carmen W. H. Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China; (K.C.C.); (W.T.C.); (J.W.H.S.)
- Correspondence: ; Tel.: +852-3943-6218
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China; (K.C.C.); (W.T.C.); (J.W.H.S.)
| | - Wai Tong Chien
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China; (K.C.C.); (W.T.C.); (J.W.H.S.)
| | - Janet W. H. Sit
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China; (K.C.C.); (W.T.C.); (J.W.H.S.)
| | - Rosa Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China;
| | - Karis K. F. Cheng
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore 119077, Singapore;
| | - Chi Kong Li
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China;
| | - Hui Leung Yuen
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong, China;
| | - Chi Keung Li
- Department of Paediatrics & Adolescent Medicine, Princess Margaret Hospital, Hong Kong, China;
| |
Collapse
|
11
|
Werk RS, Ford JS. Covariates of risky health behaviors in pediatric cancer survivors during adolescence. J Psychosoc Oncol 2020; 39:74-88. [PMID: 32713264 DOI: 10.1080/07347332.2020.1795779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Adolescent survivors of pediatric cancers may use alcohol and tobacco (73-90% and 10-29%, respectively) at similar rates as their healthy peers despite known adverse health effects of these substances. This is concerning given that these behaviors can increase the risk for adverse late effects among this population. This study explores the beliefs and behaviors associated with alcohol and tobacco use among adolescent survivors of pediatric cancer. DESIGN Cross-sectional study using assessment questionnaires by telephone. PARTICIPANTS Adolescent cancer survivors who had been seen at Memorial Sloan Kettering Cancer Center (n = 128). METHODS Questionnaires concerned participants' medical history, current health behaviors, attitudes about health behaviors, fear of cancer recurrence, cancer worry, knowledge of risk, and perceived risk of future health problems. Univariate and multiple logistic regression analyses determined the association between psychological covariates with having ever used alcohol and cigarettes. RESULTS In multiple logistic regression, higher positive attitude (OR = 3.65; p < 0.001) toward alcohol use and lower knowledge of the risk of binge drinking (OR = 0.38; p < 0.05) were significantly related to alcohol use. Older age (OR = 1.55; p < 0.01), lower knowledge of the risks of smoking (0.41; p < 0.05), and the subjective norm that smoking is desirable to others (OR = 1.90; p < 0.05) were significantly related to cigarette use. CONCLUSION AND IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Understanding the uptake of risky health behaviors and factors related to tobacco and alcohol use for adolescent survivors is imperative to promoting lifelong healthy behaviors and potentially reducing future adverse health effects. Despite broadly disseminated public service campaigns and anticipatory guidance of our cancer specialists to inform youth about the adverse effects of alcohol and tobacco use, there remains a gap in adolescent cancer survivors' knowledge of these risks. More effective interventions to increase knowledge of the risks of drinking and smoking are needed to bridge this gap.
Collapse
Affiliation(s)
- Rachel S Werk
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jennifer S Ford
- Hunter College and The Graduate Center, City University of New York, New York, New York, USA
| |
Collapse
|
12
|
Russo S, Wakefield CE, Fardell JE, Cohn RJ. Summer sun-exposure in Australian childhood cancer survivors and community reference groups. Semin Oncol 2020; 47:48-55. [PMID: 32145971 DOI: 10.1053/j.seminoncol.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 11/11/2022]
Abstract
PURPOSE Sun-exposure can cause health problems, including melanoma and nonmelanoma skin cancer, especially in Australia where the incidence of skin cancer is particularly high. Childhood cancer survivors (CCSs) have an augmented risk due to previous cancer history and treatment. Despite recommendations advising sun protection, CCSs may be placing themselves at risk. We considered daily summer sun-exposure in an Australian cohort of CCSs and in community reference groups, and identified factors associated with sun-exposure in these populations. METHODS Summer sun-exposure data were collected on 471 CCSs (119 parents of survivors aged <16, and 352 survivors aged ≥16) and a reference group of 470 participants from the community (155 parents of children aged <16, and 355 adults aged ≥16). Survivors completed paper questionnaires and the reference groups completed an online survey. Medical records confirmed survivors' clinical information. Ordinal logistic regressions identified factors associated with daily summer sun-exposure. RESULTS More daily summer sun-exposure was reported by both parents reporting for the young survivors (U = 5,522.5, P < .001; U = 31,412, P < .001) and by older survivors (U = 5,039.5, P < .001; U = 29,913, P < .001). Among younger participants greater sun-exposure was associated with being a CCS, while in older participants, greater sun-exposure was associated with being a CCS, a male, smoker/ex-smoker and was also increased in those with more sensitive skin reaction to sunlight. Focusing only on the CCSs, when treatments were considered, none statistically predicted sun-exposure in young CCSs while older CCSs who received radiotherapy were less likely to spend excess time in the sun. CONCLUSION CCSs have sun-exposure at times of day when sun-related skin damage is highest, despite advice to avoid highest risk times. This data can inform sun-protection programs and lifestyle advice aimed at ameliorating the potential increased risk of skin cancer in CCSs.
Collapse
Affiliation(s)
- Selena Russo
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia.
| | - Claire E Wakefield
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Joanna E Fardell
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Richard J Cohn
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia
| |
Collapse
|
13
|
Kasteler R, Belle F, Schindera C, Barben J, Gumy-Pause F, Tinner EM, Kuehni CE. Prevalence and reasons for smoking in adolescent Swiss childhood cancer survivors. Pediatr Blood Cancer 2019; 66:e27438. [PMID: 30239111 DOI: 10.1002/pbc.27438] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/22/2018] [Accepted: 08/01/2018] [Indexed: 11/05/2022]
Abstract
BACKGROUND Smoking harms health, particularly that of childhood cancer survivors, who face risk of pulmonary and cardiovascular diseases because of chemotherapy and radiotherapy to the chest. This nationwide study assessed smoking habits and reasons for smoking in adolescent survivors and healthy peers. METHODS As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to all Swiss resident survivors, who were aged 16-19 years. We compared smoking status and reasons for smoking between 511 survivors, 141 of their siblings, and 1,727 adolescents in a representative population-based study, the Tobacco Monitoring Switzerland (TMS). RESULTS Current smoking was less prevalent in survivors (17%) and their siblings (17%) compared with TMS (32%). Survivors and TMS adolescents gave similar reasons for smoking. Stress control, smoking being a habit, and good taste were the reasons for smoking cited most often in both groups. Peer smoking was more important in survivors (49%) than in TMS (34%, P = 0.004). Most important reasons for not smoking in both groups were smoking being unhealthy and not wanting to be addicted. CONCLUSIONS In Switzerland, survivors smoke as often as their siblings but less than the general population. Peer smoking was a more important reason for smoking in survivors than in the general population, suggesting that reducing smoking in peers could result in a reduction of smoking in survivors. Overall, reasons for smoking were very similar, thus interventions to reduce smoking in survivors could be the same as those used in the general population.
Collapse
Affiliation(s)
- Rahel Kasteler
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fabiën Belle
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Division of Chronic Diseases, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Christina Schindera
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Pediatric Hematology/Oncology, University Children`s Hospital Basel, Basel, Switzerland
| | - Jürg Barben
- Division of Pediatric Pulmonology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Fabienne Gumy-Pause
- Department of Pediatrics, Onco-hematology Unit, University Hospital of Geneva, University of Geneva, Geneva, Switzerland
| | - Eva M Tinner
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Interdisciplinary Long-term follow-up Clinic, Kantonsspital Baselland, Liestal, Switzerland
| | - Claudia E Kuehni
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | |
Collapse
|
14
|
Kim M, Choi KS, Suh M, Jun JK, Chuck KW, Park B. Risky Lifestyle Behaviors among Gastric Cancer Survivors Compared with Matched Non-cancer Controls: Results from Baseline Result of Community Based Cohort Study. Cancer Res Treat 2017; 50:738-747. [PMID: 28745037 PMCID: PMC6056967 DOI: 10.4143/crt.2017.129] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 07/11/2017] [Indexed: 01/08/2023] Open
Abstract
Purpose This study investigated the prevalence of smoking, drinking, and physical inactivity and the associated factors of these behaviors in gastric cancer survivors. Materials and Methods The baseline data from the nationwide cohort study was used. Four hundred thirty-seven gastric cancer survivors who survived ≥ 2 years from diagnosis and reported completion of treatment were matched with 4,370 controls according to age, sex, education, and household income. Results The prevalence rates of current smoking and drinking among gastric cancer survivors were 8.7% and 38.3%, which were significantly lower than those among matched controls (p ≤ 0.001), but the prevalence rates of physical inactivity were not significantly different (55.8% vs. 59.9%, p=0.248). In gastric cancer survivors, ≥ 5 years since cancer diagnosis and current drinking contributed to more current smoking; otherwise, age increment and femalewere associatedwith lower current smoking. Thosewith household income ≥ $2,000 and current smokers were more likely to drink and female showed less drinking. Female, currently employed state, and self-rated health status were associated with more physical inactivity. Conclusion Although gastric cancer survivors showed better health behaviors than controls, suggesting that the diagnosis of cancer may motivate individuals towards healthy behaviors, their current prevalence rates of smoking and drinking were still high, and more than 50% of them were physically inactive. Tailored interventions to improve their health behaviors considering associated factors for the gastric cancer survivors are necessary.
Collapse
Affiliation(s)
- Minkyung Kim
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Kui Son Choi
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jae Kwan Jun
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Kumban Walter Chuck
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Boyoung Park
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,National Cancer Control Institute, National Cancer Center, Goyang, Korea
| |
Collapse
|
15
|
Ko H, Song YM, Shin JY. Factors associated with alcohol drinking behavior of cancer survivors: The Korean National Health and Nutrition Examination Survey. Drug Alcohol Depend 2017; 171:9-15. [PMID: 28012430 DOI: 10.1016/j.drugalcdep.2016.11.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 11/08/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study aimed to evaluate the factors associated with drinking behavior of cancer survivors after cancer diagnosis. METHODS The study subjects were 906 adult cancer survivors who had reportedly drunk alcohol before cancer diagnosis and participated in the Korean National Health and Nutrition Examination Surveys conducted from 2007 to 2013. Among them, 360 abstained from alcohol drinking after cancer diagnosis. We categorized remaining 546 persistent drinkers into high-risk drinker (consuming≥7 glasses of alcohol for men and≥5 glasses of alcohol for women at one sitting at the frequency of at least once a month) or moderate drinker. We used multiple logistic regression analysis to evaluate risk factors associated with drinking behavior. RESULTS The high-risk drinkers occupied 27.1% (148 survivors) of the persistent alcohol drinking survivors. Age increase (OR=0.96; 95% CI 0.93-0.99), female sex (OR=0.15; 95% CI 0.08-0.28), and increase of time lapse (by 1-year) after cancer diagnosis (OR=0.94; 95% CI 0.92-0.97) were associated with a lower risk of high-risk drinking as compared with moderate drinking. Meanwhile,≤9years of education (OR=1.99; 95% CI 1.10-3.60), alcohol-related cancer (OR=2.09; 95% CI 1.23-3.56), and current smoking (OR=1.92; 95% CI 1.03-3.59) were associated with increased risk of high-risk drinking of cancer survivors. CONCLUSIONS These findings suggest that greater efforts for preventing high-risk drinking should be laid on the cancer survivors, with consideration of individual sociodemographic characteristics, especially when the survivors had been diagnosed with alcohol-related cancer.
Collapse
Affiliation(s)
- Hyeonyoung Ko
- Department of Family Medicine, Samsung Medical Center, SungkyunKwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Yun-Mi Song
- Department of Family Medicine, Samsung Medical Center, SungkyunKwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Jin-Young Shin
- Department of Family Medicine, Samsung Medical Center, SungkyunKwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea.
| |
Collapse
|
16
|
Marjerrison S, Hendershot E, Empringham B, Nathan PC. Smoking, Binge Drinking, and Drug Use Among Childhood Cancer Survivors: A Meta-Analysis. Pediatr Blood Cancer 2016; 63:1254-63. [PMID: 26999299 DOI: 10.1002/pbc.25943] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/20/2015] [Accepted: 01/15/2016] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Childhood cancer survivors are at risk for late effects of therapy, some of which may be exacerbated by smoking, alcohol, or drug use. We undertook a meta-analysis of the literature to determine whether survivors engage in risk-taking behaviors at rates different from their peers/siblings. METHODS Studies comparing current engagement in risk-taking behaviors between cancer survivors and siblings or matched peers were identified in MEDLINE (1946-), EMBASE (1947-), PsychINFO (1806-), and the Cochrane Controlled Trials Register. Two reviewers assessed publications for inclusion and extracted data independently. Studies were combined using inverse variance weighting to determine odds ratios (OR) and prevalence rates of risk-taking behaviors in survivors compared to controls. RESULTS Fourteen of 1,713 studies satisfied inclusion criteria. Twelve assessed smoking, six binge drinking, and seven drug use. Among survivors, 22% (95% confidence interval 0.19, 0.26) smoked, 20% (0.08, 0.51) were binge drinkers, and 15% (0.10, 0.23) used drugs. Survivors were less likely than siblings to smoke (OR 0.68 [0.49, 0.96]) or binge drink (OR 0.77 [0.68, 0.88]), but similarly likely to use drugs (OR 0.33 [0.03, 3.28]). Survivors were less likely than matched peers to smoke (OR 0.54 [0.42, 0.70]) or use drugs (OR 0.57 [0.40, 0.82]), but equally likely to binge drink (OR 0.97 [0.38, 2.49]). CONCLUSIONS Childhood cancer survivors engage in similar or lower rates of risk taking than their siblings/peers. Future studies should identify survivors most likely to benefit from focused interventions, and determine the impact of risk-taking behaviors on the risk for late effects of cancer therapy.
Collapse
Affiliation(s)
- Stacey Marjerrison
- Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Eleanor Hendershot
- Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Brianna Empringham
- Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Paul C Nathan
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
17
|
Carretier J, Boyle H, Duval S, Philip T, Laurence V, Stark DP, Berger C, Marec-Bérard P, Fervers B. A Review of Health Behaviors in Childhood and Adolescent Cancer Survivors: Toward Prevention of Second Primary Cancer. J Adolesc Young Adult Oncol 2016; 5:78-90. [DOI: 10.1089/jayao.2015.0035] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Julien Carretier
- Department of Cancer Environment, Centre Léon Bérard, Lyon, France
| | - Helen Boyle
- Dispositif Adolescents et Jeunes Adultes, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Sarah Duval
- Department of Cancer Environment, Centre Léon Bérard, Lyon, France
| | - Thierry Philip
- Department of Cancer Environment, Centre Léon Bérard, Lyon, France
| | | | - Dan P. Stark
- Department of Medical Oncology, University of Leeds, Leeds, United Kingdom
| | - Claire Berger
- Hématologie Oncologie Pédiatrique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Perrine Marec-Bérard
- Dispositif Adolescents et Jeunes Adultes, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Béatrice Fervers
- Department of Cancer Environment, Centre Léon Bérard, Lyon, France
| |
Collapse
|
18
|
Wong KF, Reulen RC, Winter DL, Guha J, Fidler MM, Kelly J, Lancashire ER, Pritchard-Jones K, Jenkinson HC, Sugden E, Levitt G, Frobisher C, Hawkins MM. Risk of Adverse Health and Social Outcomes Up to 50 Years After Wilms Tumor: The British Childhood Cancer Survivor Study. J Clin Oncol 2016; 34:1772-9. [DOI: 10.1200/jco.2015.64.4344] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose Survivors of Wilms tumor (WT) are at risk for adverse health and social outcomes but risks beyond 30 years from diagnosis remain uncertain. We investigated the risks of adverse outcomes among 5-year survivors of WT, in particular, those between 30 and 50 years from diagnosis. Patients and Methods The British Childhood Cancer Survivor Study includes 1,441 5-year survivors of WT. We investigated cause-specific mortality, risk of subsequent primary neoplasms (SPNs), and, for those who completed a questionnaire, the extent of smoking and drinking, educational achievement, health status, and health service use compared with the general population. Results Cumulative risk of death from all causes, excluding recurrence, increased substantially from 5.4% to 22.7% at 30 years and 50 years, respectively, after WT diagnosis—75% of excess deaths beyond 30 years from diagnosis were attributable to SPNs (50%) and cardiac diseases (25%). Digestive cancer, most frequently bowel, accounted for 41% of excess cancers beyond 30 years. Conclusion Between 30 and 50 years from diagnosis, survivors of WT are at a substantially increased risk of premature mortality, and 75% of excess deaths were accounted for by SPNs and cardiac diseases. Radiotherapy exposure was a risk factor for both outcomes. The proportion of patients with WT who are exposed to radiotherapy has reduced substantially in recent decades because of initiatives such as the SIOP WT 2001 clinical trial, which sought to reduce late effects; however, the majority of current survivors, who are at least 30 years from diagnosis, received radiotherapy. Surveillance of this group should focus on SPNs, in particular, bowel and breast cancers, and cardiac conditions.
Collapse
Affiliation(s)
- Kwok F. Wong
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Raoul C. Reulen
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - David L. Winter
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Joyeeta Guha
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Miranda M. Fidler
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Julie Kelly
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Emma R. Lancashire
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Kathryn Pritchard-Jones
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Helen C. Jenkinson
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Elaine Sugden
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Gill Levitt
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Clare Frobisher
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| | - Michael M. Hawkins
- Kwok F. Wong, Raoul C. Reulen, David L. Winter, Joyeeta Guha, Miranda M. Fidler, Julie Kelly, Emma R. Lancashire, Elaine Sugden, Gill Levitt, Clare Frobisher, and Michael M. Hawkins, University of Birmingham; Helen C. Jenkinson, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham; and Kathryn Pritchard-Jones, University College London and Great Ormond Street Hospital for Children, London, United Kingdom
| |
Collapse
|
19
|
Cantrell MA, Posner MA. Engagement in High-Risk Behaviors Among Young Adult Survivors of Childhood Cancer Compared to Healthy Same-Age Peers Surveyed in the National Longitudinal Study of Adolescent Health. J Adolesc Young Adult Oncol 2016; 5:146-51. [PMID: 26863292 DOI: 10.1089/jayao.2015.0053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This secondary data analysis compared smoking rates, alcohol consumption, and binge drinking, and examined risk factors for engaging in these behaviors among 90 young adult-aged childhood cancer survivors (CSS) with 15,490 young adults in the general population. METHODS The sample was drawn from the National Longitudinal Study of Adolescent Health. The sampling distribution of these healthy matched young adults was estimated through the use of bootstrapping, which involved randomly repeated for 10,000 samples of healthy controls. RESULTS The findings of repeated sampling analysis revealed that CCS were more likely to smoke daily (34.5% vs. 20.6 healthy matched controls; p = 0.03). The proportion of respondents who had any signs of alcohol abuse symptoms was 72.2% of CCS compared with 81.1% of matched controls (p = 0.16), while CCS with severe alcohol abuse was 51.1% compared with 59.1% of matched controls (p = 0.28). Whether they engaged in binge drinking in the past 12 months was 43.3% for CCS and 46.4% for healthy respondents. Logistic regression analyses were performed to examine predictors of smoking, alcohol use, and binge drinking among CCS. Smoking was very strongly associated with optimism. An optimism score of one unit higher was associated with a 39% reduction in odds of smoking (odd ratio [OR] = 0.61, p < 0.0001). Black CSS were less likely to smoke (OR = 0.15, p < 0.05). CCS in good health were more likely to binge drink (OR = 3.67, p < 0.05). CONCLUSIONS Data generated from this secondary data analyses add to the evidence base about the engagement in high risk behaviors among young adult-aged CCS. These findings further emphasize the need for widespread, available effective theory-based screening guidelines and interventions.
Collapse
Affiliation(s)
- Mary Ann Cantrell
- 1 College of Nursing, Villanova University , Villanova, Pennsylvania
| | - Michael A Posner
- 2 Department of Mathematics and Statistics, Villanova University , Villanova, Pennsylvania
| |
Collapse
|
20
|
Asfar T, Dietz NA, Arheart KL, Tannenbaum SL, McClure LA, Fleming LE, Lee DJ. Smoking behavior among adult childhood cancer survivors: what are we missing? J Cancer Surviv 2016; 10:131-41. [PMID: 26031234 DOI: 10.1007/s11764-015-0459-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/20/2015] [Indexed: 12/26/2022]
Abstract
PURPOSE Childhood cancer survivors are a growing population at increased risk for smoking-related health complications. This study compared smoking prevalence, age at smoking initiation, and time trend of smoking prevalence from 1997 to 2010 between adult survivors of childhood cancer and adults without a cancer history (controls) and identified predictors of smoking among these survivors. METHODS Data were pooled from the 1997-2010 National Health Interview Survey (survivors, n = 1438; controls, n = 383,805). Smoking prevalence by age group was calculated using weighted least square regression analysis and weighted linear regression of prevalence on year for trend analysis. Logistic regression analyses adjusting for sample weights and design effects were performed to identify predictors of smoking among survivors. RESULTS Compared to controls, survivors were significantly more likely to be younger, female, non-Hispanic White, unemployed, with lower income, and to weigh less and smoke more. Survivors initiated smoking earlier than controls. Smoking prevalence among survivors peaked at age 30 and 40 years old, compared to age 25 years in controls. Smoking prevalence decreased consistently from 1997 to 2010 among controls, with larger significant declines in survivors that were subject to more year-to-year variability. Compared to nonsmoking survivors, those who smoke were significantly more likely to be non-Hispanic White, young, uninsured, poor, to have a high school education or less, and to report drinking alcohol. CONCLUSION Smoking in adult survivors of childhood cancer continues as a persistent risk factor across socioeconomic groups. IMPLICATIONS FOR CANCER SURVIVORS Targeted and tailored smoking cessation/prevention interventions for these survivors are needed.
Collapse
Affiliation(s)
- Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, Miami, FL, 33136, USA.
| | - Noella A Dietz
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, Miami, FL, 33136, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Stacey L Tannenbaum
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Laura A McClure
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lora E Fleming
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, Miami, FL, 33136, USA
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Cornwall, UK
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, Miami, FL, 33136, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
21
|
Gibson TM, Liu W, Armstrong GT, Srivastava DK, Hudson MM, Leisenring WM, Mertens AC, Klesges RC, Oeffinger KC, Nathan PC, Robison LL. Longitudinal smoking patterns in survivors of childhood cancer: An update from the Childhood Cancer Survivor Study. Cancer 2015; 121:4035-43. [PMID: 26287647 DOI: 10.1002/cncr.29609] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/27/2015] [Accepted: 06/29/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND Survivors of pediatric cancer have elevated risks of mortality and morbidity. Many late adverse effects associated with cancer treatment (eg, second cancers and cardiac and pulmonary disease) are also associated with cigarette smoking, and this suggests that survivors who smoke may be at high risk for these conditions. METHODS This study examined the self-reported smoking status for 9397 adult survivors of childhood cancer across 3 questionnaires (median time interval, 13 years). The smoking prevalence among survivors was compared with the smoking prevalence among siblings and the prevalence expected on the basis of age-, sex-, race-, and calendar time-specific rates in the US population. Multivariable regression models examined characteristics associated with longitudinal smoking patterns across all 3 questionnaires. RESULTS At the baseline, 19% of survivors were current smokers, whereas 24% of siblings were current smokers, and 29% were expected to be current smokers on the basis of US rates. Current smoking among survivors dropped to 16% and 14% on follow-up questionnaires, with similar decreases in the sibling prevalence and the expected prevalence. Characteristics associated with consistent never-smoking included a higher household income (relative risk [RR], 1.16; 95% confidence interval [CI], 1.08-1.25), higher education (RR, 1.32; 95% CI, 1.22-1.43), and receipt of cranial radiation therapy (RR, 1.08; 95% CI, 1.03-1.14). Psychological distress (RR, 0.86; 95% CI, 0.80-0.92) and heavy alcohol drinking (RR, 0.64; 95% CI, 0.58-0.71) were inversely associated. Among ever-smokers, a higher income (RR, 1.17; 95% CI, 1.04-1.32) and education (RR, 1.23; 95% CI, 1.10-1.38) were associated with quitting, whereas cranial radiation (RR, 0.86; 95% CI, 0.76-0.97) and psychological distress (RR, 0.80; 95% CI, 0.72-0.90) were associated with not having quit. The development of adverse health conditions was not associated with smoking patterns. CONCLUSIONS Despite modest declines in smoking prevalence, the substantial number of consistent current smokers reinforces the need for continued development of effective smoking interventions for survivors.
Collapse
Affiliation(s)
- Todd M Gibson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Wei Liu
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Deo Kumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Wendy M Leisenring
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Ann C Mertens
- Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia
| | - Robert C Klesges
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
- Center for Population Sciences, Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Kevin C Oeffinger
- Department of Medicine and Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Paul C Nathan
- Department of Pediatrics, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| |
Collapse
|
22
|
Park B, Kong SY, Kim J, Kim Y, Park IH, Jung SY, Lee ES. Health Behaviors of Cancer Survivors in Nationwide Cross-Sectional Survey in Korea: Higher Alcohol Drinking, Lower Smoking, and Physical Inactivity Pattern in Survivors with Higher Household Income. Medicine (Baltimore) 2015; 94:e1214. [PMID: 26252280 PMCID: PMC4616611 DOI: 10.1097/md.0000000000001214] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study investigated the prevalence of smoking, alcohol consumption, and physical activity in cancer survivors and examined the sociodemographic factors affecting these health-related behaviors.We used data from the 4th and 5th Korean National Health and Nutrition Examination Survey conducted between 2007 and 2012, which identified 1153 cancer cases and 36,451 people without a history of cancer ≥20 years of age. We used a structured questionnaire to obtain information concerning cancer diagnosis, health-related behaviors, and sociodemographic characteristics.The proportion of cancer survivors who were current drinkers, heavy drinkers, current smokers, or engaged in physical activity were 49.1, 9.0, 9.2, or 50.7%, respectively. Compared with people with no history of cancer, cancer survivors were less likely to be current drinkers (odds ratio [OR] = 0.45; 95% confidence interval [CI] 0.36-0.56), heavy drinkers (OR = 0.53; 95% CI 0.36-0.78), current smokers (OR = 0.37; 95% CI 0.24-0.55), or physically inactive (OR = 0.77; 95% CI 0.63-0.95). Cancer survivors with higher household incomes had higher odds of current drinking and heavy drinking (P trend = 0.039 and 0.033, respectively) and were less likely to be current smokers or physically inactive (P trend = 0.016 and 0.046, respectively). Age, sex, sites of cancer, and the time since diagnosis affected the health behaviors in cancer survivors. Furthermore, we confirmed that these unhealthy behaviors are interrelated.We found that household income had a bidirectional effect on health behaviors and confirmed an aggregation of unhealthy lifestyles. Identification of survivors vulnerable to unhealthy lifestyles, focusing on household income level would allow intervention programs to be more effective.
Collapse
Affiliation(s)
- Boyoung Park
- From the Graduate School of Cancer Science and Policy (BP, S-YK, JK, YK, ESL); National Cancer Control Institute (BP, YK, ESL); Research Institute (S-YK, JK, ESL); and Hospital (S-YK, YK, IHP, S-YJ, ESL), National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do Korea
| | | | | | | | | | | | | |
Collapse
|
23
|
Duval S, Carretier J, Boyle H, Philip T, Berger C, Marec-Bérard P, Fervers B. [Life style and occupational factors and prevention of second primary cancers after childhood and adolescent cancer: Current state of knowledge]. Bull Cancer 2015; 102:665-73. [PMID: 25936990 DOI: 10.1016/j.bulcan.2015.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 03/31/2015] [Indexed: 01/22/2023]
Abstract
CONTEXT Survival of children, adolescents and young adults treated for cancer increased with improved treatments. But there is still an increased risk of second primary cancer (SPC) in the long term compared to the population of the same age, especially related to treatments. A reflection on the follow-up of this population and the prevention of SPC is an important issue. OBJECTIVES To perform a synthesis of the available literature on SCP risk factors, related risk behaviors, occupational exposures and prevention strategies. METHODS Literature search on PubMed from the following equation: "cancer [Tiab] AND young adult [Tiab] or teen [Tiab] or childhood [Tiab] AND prevention [Tiab] AND survivors [Mesh term]". RESULTS Twenty-seven articles were included in this synthesis. Children, adolescents and young adults have similar risk behaviors than those of their peers regarding tobacco, diet and sun exposure; however, they have lower physical activity. There are few studies on prevention strategies focused on this population. Results of available studies remain inconclusive. No publication was found in relation to occupational exposure and risk of second cancer. CONCLUSIONS Children, adolescents and young adults treated for cancer are a population at risk and require long-term follow-up and the implementation of effective prevention strategies tailored to this population.
Collapse
Affiliation(s)
- Sarah Duval
- Centre Léon-Bérard, unité cancer et environnement, 28, rue Laënnec, 69008 Lyon, France
| | - Julien Carretier
- Centre Léon-Bérard, unité cancer et environnement, 28, rue Laënnec, 69008 Lyon, France; Université de Lyon, université Claude-Bernard Lyon I, laboratoire « Santé, Individu, Société », EAM 4128, faculté de médecine Laënnec, 7-11, rue Guillaume-Paradin-Bât B, 69372 Lyon cedex 08, France.
| | - Helen Boyle
- Centre Léon-Bérard, département de médecine, 28, rue Laënnec, 69373 Lyon cedex 08, France
| | - Thierry Philip
- Centre Léon-Bérard, unité cancer et environnement, 28, rue Laënnec, 69008 Lyon, France
| | - Claire Berger
- Centre hospitalier universitaire de Saint-Etienne, service d'hématologie oncologie pédiatrique, 42055 Saint-Etienne cedex 2, France
| | - Perrine Marec-Bérard
- Institut d'hématologie et d'oncologie pédiatrique, centre Léon-Bérard, 69373 Lyon cedex 08, France
| | - Béatrice Fervers
- Centre Léon-Bérard, unité cancer et environnement, 28, rue Laënnec, 69008 Lyon, France; Université de Lyon, université Claude-Bernard Lyon I, laboratoire « Santé, Individu, Société », EAM 4128, faculté de médecine Laënnec, 7-11, rue Guillaume-Paradin-Bât B, 69372 Lyon cedex 08, France
| |
Collapse
|
24
|
Abstract
PURPOSE OF REVIEW Adolescents and young adults with special health care needs (SHCN) are uniquely vulnerable to health risk behaviors including smoking, alcohol and illicit drug use, and sexual risk-taking. Their likelihood of experiencing adverse health outcomes because of these behaviors may be beyond that experienced by their healthier peer group. Pediatric providers are responsible for appropriately counseling these patients about healthy lifestyles. This review provides some background regarding these health risks among adolescents and young adults with SHCN with particular focus on three populations: childhood cancer survivors, congenital heart disease patients, and those with intellectual disability. RECENT FINDINGS Young adults and adolescents with chronic medical conditions are as likely - and perhaps more likely - to engage in health risk behaviors. However, these behaviors are not fully addressed by primary care providers. SUMMARY Pediatric providers are encouraged to ask adolescents and young adults with SHCN about their understanding of, and engagement in, health risk behaviors. A multidisciplinary approach to encourage a healthy lifestyle within this population may have significant health benefits.
Collapse
|
25
|
Hudson MM, Oeffinger KC, Jones K, Brinkman TM, Krull KR, Mulrooney DA, Mertens A, Castellino SM, Casillas J, Gurney JG, Nathan PC, Leisenring W, Robison LL, Ness KK. Age-dependent changes in health status in the Childhood Cancer Survivor cohort. J Clin Oncol 2014; 33:479-91. [PMID: 25547510 DOI: 10.1200/jco.2014.57.4863] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To compare age-dependent changes in health status among childhood cancer survivors and a sibling cohort. METHODS Adult survivors of childhood cancer and siblings, all participants of the Childhood Cancer Survivor Study, completed three surveys assessing health status. At each of three time points, participants were classified as having poor outcomes in general health, mental health, function, or daily activities if they indicated moderate to extreme impairment. Generalized linear mixed models were used to compare survivors with siblings for each outcome as a function of age and to identify host- and treatment-related factors associated with age-dependent worsening health status. RESULTS Adverse health status outcomes were more frequent among survivors than siblings, with evidence of a steeper trajectory of age-dependent change among female survivors with impairment in at least one health status domain (P = .01). In adjusted models, survivors were more likely than siblings to report poor general health (prevalence ratio [PR], 2.37; 95% CI, 2.09 to 2.68), adverse mental health (PR, 1.66; 95% CI, 1.52 to 1.80), functional impairment (PR, 4.53; 95% CI, 3.91 to 5.24), activity limitations (PR, 2.38; 95% CI, 2.12 to 2.67), and an adverse health status outcome in any domain (PR, 2.10; 95% CI, 1.97 to 2.23). Cancer treatment and health behaviors influence the magnitude of differences by age groups. Chronic conditions were associated with adverse health status outcomes across organ systems. CONCLUSION The prevalence of poor health status is higher among survivors than siblings, increases rapidly with age, particularly among female participants, and is related to an increasing burden of chronic health conditions.
Collapse
Affiliation(s)
- Melissa M Hudson
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada.
| | - Kevin C Oeffinger
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Kendra Jones
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Tara M Brinkman
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Kevin R Krull
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Daniel A Mulrooney
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Ann Mertens
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Sharon M Castellino
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Jacqueline Casillas
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - James G Gurney
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Paul C Nathan
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Wendy Leisenring
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Leslie L Robison
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Kirsten K Ness
- Melissa M. Hudson, Kendra Jones, Tara M. Brinkman, Kevin R. Krull, Daniel A. Mulrooney, James G. Gurney, Leslie L. Robison, Kirsten K. Ness, St Jude Children's Research Hospital; James G. Gurney, University of Memphis School of Public Health, Memphis, TN; Kevin C. Oeffinger, Memorial Sloan-Kettering Cancer Center, New York, NY; Ann Mertens, Emory University, Children's Healthcare of Atlanta, Atlanta, GA; Sharon M. Castellino, Wake Forest School of Medicine, Winston-Salem, NC; Jacqueline Casillas, University of California, Los Angeles, Los Angeles, CA; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Paul C. Nathan, Hospital for Sick Children and University of Toronto, Toronto, Canada
| |
Collapse
|
26
|
Health Behaviors of Childhood Cancer Survivors. CHILDREN-BASEL 2014; 1:355-73. [PMID: 27417484 PMCID: PMC4928744 DOI: 10.3390/children1030355] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/11/2014] [Accepted: 10/15/2014] [Indexed: 12/30/2022]
Abstract
There has been a dramatic increase in the number of childhood cancer survivors living to an old age due to improved cancer treatments. However, these survivors are at risk of numerous late effects as a result of their cancer therapy. Engaging in protective health behaviors and limiting health damaging behaviors are vitally important for these survivors given their increased risks. We reviewed the literature on childhood cancer survivors’ health behaviors by searching for published data and conference proceedings. We examine the prevalence of a variety of health behaviors among childhood cancer survivors, identify significant risk factors, and describe health behavior interventions for survivors.
Collapse
|
27
|
Breitenbach K, Epstein-Reeves M, Hacker E, Corte C, Piano MR. Alcohol Use Assessment in Young Adult Cancer Survivors. Oncol Nurs Forum 2014; 41:517-22. [DOI: 10.1188/14.onf.41-05ap] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
28
|
Oswald LM, Wand GS, Kuwabara H, Wong DF, Zhu S, Brasic JR. History of childhood adversity is positively associated with ventral striatal dopamine responses to amphetamine. Psychopharmacology (Berl) 2014; 231:2417-33. [PMID: 24448898 PMCID: PMC4040334 DOI: 10.1007/s00213-013-3407-z] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 12/11/2013] [Indexed: 12/17/2022]
Abstract
RATIONALE Childhood exposure to severe or chronic trauma is an important risk factor for the later development of adult mental health problems, such as substance abuse. Even in nonclinical samples of healthy adults, persons with a history of significant childhood adversity seem to experience greater psychological distress than those without this history. Evidence from rodent studies suggests that early life stress may impair dopamine function in ways that increase risks for drug abuse. However, the degree to which these findings translate to other species remains unclear. OBJECTIVES This study was conducted to examine associations between childhood adversity and dopamine and subjective responses to amphetamine in humans. METHODS Following intake assessment, 28 healthy male and female adults, aged 18-29 years, underwent two consecutive 90-min positron emission tomography studies with high specific activity [(11)C]raclopride. The first scan was preceded by intravenous saline; the second by amphetamine (AMPH 0.3 mg/kg). RESULTS Consistent with prior literature, findings showed positive associations between childhood trauma and current levels of perceived stress. Moreover, greater number of traumatic events and higher levels of perceived stress were each associated with higher ventral striatal dopamine responses to AMPH. Findings of mediation analyses further showed that a portion of the relationship between childhood trauma and dopamine release may be mediated by perceived stress. CONCLUSIONS Overall, results are consistent with preclinical findings suggesting that early trauma may lead to enhanced sensitivity to psychostimulants and that this mechanism may underlie increased vulnerability for drug abuse.
Collapse
Affiliation(s)
- Lynn M. Oswald
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA,Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Gary S. Wand
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA,Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Hiroto Kuwabara
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Dean F. Wong
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA,Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA,Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA,Department of Environmental Health Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Shijun Zhu
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA
| | - James R. Brasic
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| |
Collapse
|
29
|
Berbis J, Michel G, Baruchel A, Bertrand Y, Chastagner P, Demeocq F, Kanold J, Leverger G, Plantaz D, Poirée M, Stephan JL, Auquier P, Contet A, Dalle JH, Ducassou S, Gandemer V, Lutz P, Sirvent N, Tabone MD, Thouvenin-Doulet S. Cohort Profile: the French childhood cancer survivor study for leukaemia (LEA Cohort). Int J Epidemiol 2014; 44:49-57. [PMID: 24639445 DOI: 10.1093/ije/dyu031] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The main aim of the Leucémies de l'Enfant et l'Adolescent (LEA) project (Childhood and Adolescent Leukaemia) is to study the determinants (medical, socioeconomic, behavioural and environmental) of medium- and long-term outcomes of patients treated for childhood acute leukaemia (AL). The LEA study began in 2004 and is based on a French multicentric prospective cohort. Included are children treated for AL since January 1980 (incident and prevalent cases), surviving at month 24 for myeloblastic AL and lymphoblastic AL grafted in first complete remission or at month 48 for lymphoblastic AL not grafted in first complete remission. Information is collected during specific medical visits and notably includes the following data: socioeconomic data, AL history, physical late effects (such as fertility, cardiac function and metabolic syndrome) and quality of life. Data are collected every 2 years until the patient is 20 years old and has had a 10-year follow-up duration from diagnosis or last relapse. Thereafter, assessments are planned every 4 years. In active centres in 2013, eligible patients number more than 3000. The cohort has already included 2385 survivors, with rate of exhaustiveness of almost 80%. Data access can be requested from principal coordinators and must be approved by the steering committee.
Collapse
Affiliation(s)
- Julie Berbis
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Gérard Michel
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - André Baruchel
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric
| | - Yves Bertrand
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Pascal Chastagner
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - François Demeocq
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Justyna Kanold
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Guy Leverger
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Dominique Plantaz
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Marilyne Poirée
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Jean-Louis Stephan
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Pascal Auquier
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Audrey Contet
- Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France
| | - Jean-Hugues Dalle
- Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France
| | - Stéphane Ducassou
- Department of Paediatric Onco-haematology, University Hospital of Bordeaux, Bordeaux, France
| | - Virginie Gandemer
- Department of Paediatric Onco-haematology, University Hospital of Rennes, Rennes, France
| | - Patrick Lutz
- Department of Paediatric Onco-haematology, University Hospital of Strasbourg, Strasbourg, France
| | - Nicolas Sirvent
- Department of Paediatric Onco-haematology, University Hospital of Montpellier, Montpellier, France
| | - Marie-Dominique Tabone
- Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France
| | - Sandrine Thouvenin-Doulet
- Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| |
Collapse
|
30
|
Lipshultz SE, Adams MJ, Colan SD, Constine LS, Herman EH, Hsu DT, Hudson MM, Kremer LC, Landy DC, Miller TL, Oeffinger KC, Rosenthal DN, Sable CA, Sallan SE, Singh GK, Steinberger J, Cochran TR, Wilkinson JD. Long-term cardiovascular toxicity in children, adolescents, and young adults who receive cancer therapy: pathophysiology, course, monitoring, management, prevention, and research directions: a scientific statement from the American Heart Association. Circulation 2013; 128:1927-95. [PMID: 24081971 DOI: 10.1161/cir.0b013e3182a88099] [Citation(s) in RCA: 369] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
31
|
Yağci-Küpeli B, Yalçin B, Küpeli S, Varan A, Akyüz C, Kutluk T, Büyükpamukçu M. Educational achievement, employment, smoking, marital, and insurance statuses in long-term survivors of childhood malignant solid tumors. J Pediatr Hematol Oncol 2013; 35:129-33. [PMID: 23412588 DOI: 10.1097/mph.0b013e318284127d] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVE Survivors of childhood cancer experience many social adaptation problems. We aimed to identify social, educational, and occupational issues of this growing population. PATIENTS AND METHODS Survivors treated for childhood malignant solid tumors who were older than 18 years and in remission for at least 3 years were surveyed. The educational achievement, employment, type of habitation, marital status, parenthood, social insurance, and smoking status of the patients were inquired and recorded. RESULTS Two hundred one patients (126 male patients/75 female patients) were included in the study between 2007 and 2009. The median ages at the time of diagnosis and at the time of study were 10 years (range, 0 to 19 y) and 23 years (range, 18 to 39 y), respectively. The median follow-up duration was 13.5 years (range, 3 to 31 y). Nearly half of the participants were lymphoma survivors. One hundred eleven (55.5%) survivors were high school graduates and 47 (23%) were university graduates. Unemployment rate was 36.8%. Public social insurance rate was 90.5%. Fifty-three (26.4%) survivors had independent habitation. Thirty percent of survivors were married and 7.5% had at least 1 child. Marriage rates were significantly higher in survivors who were older than 23 years, had a follow-up duration of >13 years, had a job, and lived independently (for each parameter P=0.001). University degree was significantly lower in survivors who were treated for central nervous system tumors. CONCLUSIONS Our results have drawn a more marked picture with lower educational achievement and marital rates when compared with the results of large survivorship studies conducted in developed countries. However, they can be interpreted as intriguing when limited resources are taken into account.
Collapse
Affiliation(s)
- Begül Yağci-Küpeli
- Department of Pediatric Oncology, Hacettepe University, Sihhiye, Ankara, Turkey.
| | | | | | | | | | | | | |
Collapse
|
32
|
Rebholz CE, Rueegg CS, Michel G, Ammann RA, von der Weid NX, Kuehni CE, Spycher BD. Clustering of health behaviours in adult survivors of childhood cancer and the general population. Br J Cancer 2012; 107:234-42. [PMID: 22722311 PMCID: PMC3394979 DOI: 10.1038/bjc.2012.250] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 04/30/2012] [Accepted: 05/04/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Little is known about engagement in multiple health behaviours in childhood cancer survivors. METHODS Using latent class analysis, we identified health behaviour patterns in 835 adult survivors of childhood cancer (age 20-35 years) and 1670 age- and sex-matched controls from the general population. Behaviour groups were determined from replies to questions on smoking, drinking, cannabis use, sporting activities, diet, sun protection and skin examination. RESULTS The model identified four health behaviour patterns: 'risk-avoidance', with a generally healthy behaviour; 'moderate drinking', with higher levels of sporting activities, but moderate alcohol-consumption; 'risk-taking', engaging in several risk behaviours; and 'smoking', smoking but not drinking. Similar proportions of survivors and controls fell into the 'risk-avoiding' (42% vs 44%) and the 'risk-taking' cluster (14% vs 12%), but more survivors were in the 'moderate drinking' (39% vs 28%) and fewer in the 'smoking' cluster (5% vs 16%). Determinants of health behaviour clusters were gender, migration background, income and therapy. CONCLUSION A comparable proportion of childhood cancer survivors as in the general population engage in multiple health-compromising behaviours. Because of increased vulnerability of survivors, multiple risk behaviours should be addressed in targeted health interventions.
Collapse
Affiliation(s)
- C E Rebholz
- Institute of Social and Preventive Medicine, Swiss Childhood Cancer Registry, University of Bern, Bern, Switzerland
| | - C S Rueegg
- Institute of Social and Preventive Medicine, Swiss Childhood Cancer Registry, University of Bern, Bern, Switzerland
| | - G Michel
- Institute of Social and Preventive Medicine, Swiss Childhood Cancer Registry, University of Bern, Bern, Switzerland
| | - R A Ammann
- Department of Paediatrics, University of Bern, Bern, Switzerland
| | - N X von der Weid
- Paediatric Hematology-Oncology Unit, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - C E Kuehni
- Institute of Social and Preventive Medicine, Swiss Childhood Cancer Registry, University of Bern, Bern, Switzerland
| | - B D Spycher
- Institute of Social and Preventive Medicine, Swiss Childhood Cancer Registry, University of Bern, Bern, Switzerland
| |
Collapse
|
33
|
Tai E, Buchanan N, Townsend J, Fairley T, Moore A, Richardson LC. Health status of adolescent and young adult cancer survivors. Cancer 2012; 118:4884-91. [PMID: 22688896 DOI: 10.1002/cncr.27445] [Citation(s) in RCA: 245] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 11/28/2011] [Accepted: 12/13/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adolescents and young adults (AYA) ages 15 to 29 years who are diagnosed with cancer are at risk for long-term morbidity and mortality associated with treatment of their cancer and the cancer itself. In this article, the authors describe the self-reported health status of AYA cancer survivors. METHODS The authors examined 2009 data from the Behavioral Risk Factor Surveillance System, including demographic characteristics, risk behaviors, chronic conditions, health status, and health care access, among AYA cancer survivors compared with respondents who had no history of cancer. RESULTS The authors identified 4054 AYA cancer survivors and 345,592 respondents who had no history of cancer. AYA cancer survivors, compared with respondents who had no history of cancer, reported a significantly higher prevalence of current smoking (26% vs 18%); obesity (31% vs 27%); chronic conditions, including cardiovascular disease (14% vs 7%), hypertension (35% vs 29%), asthma (15% vs 8%), disability (36% vs 18%), and poor mental health (20% vs 10%) and physical health (24% vs 10%); and not receiving medical care because of cost (24% vs 15%). CONCLUSIONS AYA cancer survivors commonly reported adverse behavioral, medical, and health care access characteristics that may lead to poor long-term medical and psychosocial outcomes. Increased adherence to established follow-up guidelines may lead to improved health among AYA cancer survivors.
Collapse
Affiliation(s)
- Eric Tai
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
| | | | | | | | | | | |
Collapse
|
34
|
Kahalley LS, Robinson LA, Tyc VL, Hudson MM, Leisenring W, Stratton K, Mertens AC, Zeltzer L, Robison LL, Hinds PS. Risk factors for smoking among adolescent survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Pediatr Blood Cancer 2012; 58:428-34. [PMID: 21618409 PMCID: PMC3165077 DOI: 10.1002/pbc.23139] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Accepted: 03/02/2011] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few studies have examined risk factors for smoking among adolescent survivors of childhood cancer. The present study reports on the rate of smoking and identifies factors associated with smoking in a sample of adolescent survivors from the Childhood Cancer Survivor Study (CCSS). PROCEDURE Participants included 307 adolescent survivors and 97 healthy siblings (ages 14-20) who completed a self-report survey of health, quality of life, and health behaviors. RESULTS Smoking rates did not differ significantly between survivor and sibling groups (ever smokers: 28% vs. 33%, recent smokers: 10% vs. 9%, respectively). Ever smoking was significantly associated with peer smoking, smokers in the household, binging, suicidal behavior, and no history of CRT. There were significant interactions of peer smoking with gender and CRT for ever smoking and with binging for recent smoking. Recent smoking was more likely for survivors with other household smokers (RR=2.24, CI=1.21-4.16), past suicidality (RR=1.89, CI=1.00-3.56), and no CRT (RR=2.40, CI=1.12-5.17). Among survivors with few smoking friends, ever smoking was more likely for survivors with no CRT (RR=4.47, CI=1.43-13.9), and recent smoking was more likely among survivors who binged (RR=3.37, CI=1.17-9.71). CONCLUSIONS Despite the health risks associated with survivorship, nearly one in three adolescent survivors of childhood cancer has smoked. Exposure to other smokers, in particular, appears to increase the likelihood of smoking for some survivors. Providing smoking cessation programs targeted to family members, helping survivors choose non-smoking friends, and teaching ways to resist smoking influences from peers may be important pathways for smoking prevention with adolescent survivors.
Collapse
Affiliation(s)
- Lisa S. Kahalley
- Department of Pediatrics, Section of Psychology, Baylor College of Medicine, Houston TX
| | | | - Vida L. Tyc
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Melissa M. Hudson
- Division of Cancer Survivorship, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Wendy Leisenring
- Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kayla Stratton
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Lonnie Zeltzer
- Department of Pediatrics and Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center and School of Medicine, Los Angeles, CA
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Pamela S. Hinds
- Department of Nursing Research and Quality Outcomes, Children’s National Medical Center, Washington, DC,
Department of Pediatrics, George Washington University, Washington, DC
| |
Collapse
|
35
|
Martin A, Kadan-Lottick N. Hazardous drinking: childhood cancer survivors at heightened risk as young adults. Pediatr Blood Cancer 2012; 58:161-2. [PMID: 21922649 DOI: 10.1002/pbc.23323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 08/02/2011] [Indexed: 11/12/2022]
|
36
|
Rebholz CE, Kuehni CE, Strippoli MPF, Rueegg CS, Michel G, Hengartner H, Bergstraesser E, von der Weid NX. Alcohol consumption and binge drinking in young adult childhood cancer survivors. Pediatr Blood Cancer 2012; 58:256-64. [PMID: 22162398 DOI: 10.1002/pbc.23289] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 06/29/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND This study compared frequency of alcohol consumption and binge drinking between young adult childhood cancer survivors and the general population in Switzerland, and assessed its socio-demographic and clinical determinants. PROCEDURE Childhood cancer survivors aged <16 years when diagnosed 1976-2003, who had survived >5 years and were currently aged 20-40 years received a postal questionnaire. Reported frequency of alcohol use and of binge drinking were compared to the Swiss Health Survey, a representative general population survey. Determinants of frequent alcohol consumption and binge drinking were assessed in a multivariable logistic regression. RESULTS Of 1,697 eligible survivors, 1,447 could be contacted and 1,049 (73%) responded. Survivors reported more often than controls to consume alcohol frequently (OR = 1.7; 95%CI = 1.3-2.1) and to engage in binge drinking (OR = 2.9; 95%CI = 2.3-3.8). Peak frequency of binge drinking in males occurred at age 24-26 years in survivors, compared to age 18-20 in the general population. Socio-demographic factors (male gender, high educational attainment, French and Italian speaking, and migration background from Northern European countries) were most strongly associated with alcohol consumption patterns among both survivors and controls. CONCLUSIONS The high frequency of alcohol consumption found in this study is a matter of concern. Our data suggest that survivors should be better informed on the health effects of alcohol consumption during routine follow-up, and that such counseling should be included in clinical guidelines. Future research should study motives of alcohol consumption among survivors to allow development of targeted health interventions for this vulnerable group.
Collapse
Affiliation(s)
- Cornelia E Rebholz
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Zwemer EK, Mahler HIM, Werchniak AE, Recklitis CJ. Sun exposure in young adult cancer survivors on and off the beach: results from Project REACH. J Cancer Surviv 2011; 6:63-71. [PMID: 22002547 DOI: 10.1007/s11764-011-0201-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 09/26/2011] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although cancer survivors are at risk for future skin cancers, many do not practice recommended sun protection. Studies have demonstrated poor adherence to specific behaviors (e.g., sunscreen, artificial tanning) during sunbathing, but less is known about survivors' typical amount of sun exposure during activities other than sunbathing. METHODS We conducted a mailed survey of 153 adults (median age = 26.1) diagnosed with a non-skin cancer before age 30. Information on recent sunbathing and incidental sun exposures, protective behaviors, and perceived vulnerability was collected. Analyses focused on characterizing survivors with the lowest levels of recommended sun protection. RESULTS Twenty-nine percent of participants exhibited low sun protection adherence during sunbathing and 31% during incidental exposure. Younger age was associated with low adherence, but this difference was significant only for sunbathing (OR=0.4; 95% CI, 0.2-0.9). Women were more likely than men to have low adherence during sunbathing (34.0% vs. 20.3%; OR = 2.44; 95% CI, 1.1-5.5). Survivors treated with radiation did not differ on exposures, adherence, or perceived vulnerability to the sun, despite feeling more susceptible to skin cancers (p = 0.03). CONCLUSIONS Despite known skin cancer risks, many young cancer survivors receive significant sun exposure. Assessment of sunbathing alone fails to capture sun exposure behaviors, particularly in men. Survivors treated with radiation may recognize their increased risk of skin cancer, but not the role of sun protection in modifying that risk.
Collapse
Affiliation(s)
- Eric K Zwemer
- Perini Family Survivors' Center, Dana-Farber Cancer Institute/Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA
| | | | | | | |
Collapse
|
38
|
Frobisher C, Lancashire ER, Reulen RC, Winter DL, Stevens MC, Hawkins MM. Extent of Alcohol Consumption among Adult Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev 2010; 19:1174-84. [DOI: 10.1158/1055-9965.epi-10-0006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|