Demark-Wahnefried W, Peterson B, McBride C, Lipkus I, Clipp E
Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Cancer. 2000 Feb 1;88(3):674-84.
Cancer survivors are at increased risk for developing secondary tumors, diabetes, osteoporosis, and cardiovascular disease, thus making them an important target population for health-related interventions. However, little is known regarding cancer survivors' behaviors and their interest in pursuing healthier diets, exercise, and smoking cessation.
A 65-item survey was mailed to 1667 patients diagnosed with early stage carcinoma of the breast or prostate that requested data regarding demographics, health behaviors, stage of readiness for smoking cessation, exercise, increased fruit and vegetable (F&V) consumption, and decreased fat intake, as well as interest in specific health programs and when, relative to diagnosis, these programs should be offered.
Responses from 978 cancer survivors suggested that the overwhelming majority (85%) reported their health as good to excellent. The majority of respondents (55%) ate fewer than 5 daily servings of F&Vs, with prostate carcinoma patients reporting eating significantly fewer servings than patients with breast carcinoma (P < 0.001). In contrast, 69% of respondents reported adherence to a low fat diet, again with lower practice rates among prostate carcinoma patients than patients with breast carcinoma (P = 0.006). The majority of respondents (58%) reported routine exercise and 8% were current smokers. Significantly more breast carcinoma patients than prostate carcinoma patients were current smokers (P = 0.03). There was strong interest in health promotion programs across behaviors, and a fair amount of concordance between low fat dietary behaviors and exercise, as well as consumption of five daily servings of F&Vs. The majority of patients expressed a preference for programs that could be delivered via mailed brochure, with 57% of respondents indicating that programs should be initiated at the time of diagnosis or soon after (within 6 months).
The results of the current study suggest that although many cancer survivors already practice healthy life-style behaviors, there is a substantial proportion who do not. Interventions especially are needed to increase daily F&V intake; however, given the fair degree of clustering between dietary and exercise behaviors, multiple risk factor interventions also may be warranted. Among cancer survivors, receptivity is high for health promotion programs, especially those that can be delivered by mail and soon after diagnosis.
癌症幸存者患继发性肿瘤、糖尿病、骨质疏松症和心血管疾病的风险增加,因此他们成为健康相关干预措施的重要目标人群。然而,对于癌症幸存者的行为以及他们对追求更健康饮食、锻炼和戒烟的兴趣了解甚少。
向1667名被诊断为早期乳腺癌或前列腺癌的患者邮寄了一份包含65个条目的调查问卷,该问卷要求提供有关人口统计学、健康行为、戒烟准备阶段、锻炼、增加水果和蔬菜(F&V)摄入量、减少脂肪摄入量的数据,以及对特定健康计划的兴趣,以及相对于诊断而言,这些计划应在何时提供。
978名癌症幸存者的回复表明,绝大多数(85%)报告自己的健康状况良好至极佳。大多数受访者(55%)每天食用的F&V份数少于5份,前列腺癌患者报告的食用份数明显少于乳腺癌患者(P < 0.001)。相比之下,69%的受访者报告坚持低脂饮食,同样前列腺癌患者的实践率低于乳腺癌患者(P = 0.006)。大多数受访者(58%)报告有日常锻炼,8%为当前吸烟者。当前吸烟者中,乳腺癌患者明显多于前列腺癌患者(P = 0.03)。对各种行为的健康促进计划都有浓厚兴趣,并且低脂饮食行为与锻炼以及每天食用5份F&V之间存在相当程度的一致性。大多数患者表示更喜欢通过邮寄宣传册提供的计划,57%的受访者表示计划应在诊断时或之后不久(6个月内)启动。
当前研究结果表明,尽管许多癌症幸存者已经践行健康的生活方式行为,但仍有相当一部分人没有。尤其需要采取干预措施来增加每日F&V摄入量;然而,鉴于饮食和锻炼行为之间存在一定程度的聚集性,也可能有必要进行多风险因素干预。在癌症幸存者中,对健康促进计划的接受度很高族,尤其是那些可以在诊断后不久通过邮寄方式提供的计划。