Multiple health behaviors before and after a cancer diagnosis among women: A repeated cross-sectional analysis over 15 years.

BACKGROUND

Cancer diagnosis may be a cue for health behavior change. Previous research that assessed the impact of a cancer diagnosis on multiple health behavior (MHB) change is limited by small sample size, cross-sectional study design, and a focus on individual rather than multiple behaviors. This study investigated the impact of a cancer diagnosis on compliance with MHB recommendations.

METHODS

Data from Australian Longitudinal Study on Women's Health (ALSWH) were utilized. Compliance with MHB was assessed by cancer survivorship period; 0-3 years pre-diagnosis, 0-3 years postdiagnosis, 4-12 years postdiagnosis, and compared to controls. A MHB score based on the WCRF/AICR guidelines was calculated for six behaviors (physical activity, smoking, alcohol, BMI, fruit, and vegetable intake); scores ranged from 0 to 6, with a higher score indicating higher compliance. Generalized estimating equation (GEE) was used for statistical analysis.

RESULTS

Participants comprised 7585 women from the 2001 ALSWH survey, of whom 2285 developed cancer during 15 years of follow-up. Compared to controls, the mean MHB score was slightly lower (Mean Difference (MD) = -0.015, P > .05) in survivors pre-diagnosis, after adjusting for confounders; however, the compliance score increased during postdiagnosis, with the mean difference score being significantly higher in recent survivors (0-3 years post diagnosis; MD = 0.055, P < .01). Likewise, within cancer survivors, the mean compliance score significantly increased 0-3 years postdiagnosis (MD = 0.07, P < .05) compared to pre-diagnosis, but this significant improvement was not maintained over the longer term (MD = 0.037, P > .05).

CONCLUSION

In this sample, survivors had higher MHB score than controls. A cancer diagnosis may provide a teachable moment for health behavior change in the period immediately following diagnosis, but this effect was not sustained during longer-term survivorship.