GW Milken Institute School of Public Health, Department of Epidemiology, Washington D.C.
GW Cancer Center, Washington D.C.
Cancer Epidemiol Biomarkers Prev. 2020 Jun;29(6):1179-1187. doi: 10.1158/1055-9965.EPI-19-1318. Epub 2020 May 14.
The 16.9 million cancer survivors in the United States are at increased risk for comorbidities and recurrence. However, this risk may be attenuated by a healthy lifestyle. This study describes health behaviors by cancer history to inform behavior change priorities.
We analyzed 2013-2017 data from the National Health Interview Survey. There were 164,692 adults, of whom 12,648 reported a cancer history. We calculated prevalence of smoking, physical activity, alcohol consumption, body mass index (BMI), and sleep duration by cancer history, age, and cancer site. We conducted logistic regression to determine odds of meeting lifestyle recommendations by cancer history.
Overall, those with a cancer history were less likely to report current smoking (14.1% vs. 16.8%) and moderate/heavy drinking (18.8% vs. 21.9%) than those without a cancer history. However, a lower percentage of cancer survivors met physical activity guidelines (14.2% vs. 21.1%) or reported a healthy BMI (31.6% vs. 34.7%) compared with those without a cancer history. Cancer survivors were more likely to report excessive sleep (6.8% vs. 3.6%). In adjusted logistic regression, survivors were more likely to meet recommendations on smoking, physical activity, and BMI but were less likely to meet alcohol recommendations; meeting sleep recommendations did not differ by cancer history.
While cancer survivors had lower prevalence of smoking and moderate/heavy drinking, they also had lower prevalence of physical activity and healthy BMI, and reported longer sleep duration. Regression analyses suggested survivors only showed poorer behaviors for alcohol.
Targeted health promotion interventions among cancer survivors are needed.
美国有 1690 万癌症幸存者，他们有更高的共病和复发风险。然而，健康的生活方式可能会降低这种风险。本研究通过癌症史描述健康行为，为行为改变提供重点。
我们分析了 2013-2017 年全国健康访谈调查的数据。共有 164692 名成年人，其中 12648 人报告有癌症史。我们根据癌症史、年龄和癌症部位计算了吸烟、体育活动、饮酒、身体质量指数（BMI）和睡眠时间的患病率。我们进行了逻辑回归分析，以确定癌症史与生活方式建议的符合率。
总体而言，有癌症史的人比没有癌症史的人更不可能报告目前吸烟（14.1%比 16.8%）和中度/重度饮酒（18.8%比 21.9%）。然而，与没有癌症史的人相比，癌症幸存者更不可能达到体育活动指南（14.2%比 21.1%）或报告健康的 BMI（31.6%比 34.7%）。与没有癌症史的人相比，癌症幸存者更有可能报告睡眠时间过长（6.8%比 3.6%）。在调整后的逻辑回归中，幸存者更有可能符合吸烟、体育活动和 BMI 的建议，但更不可能符合饮酒建议；睡眠建议的符合情况与癌症史无关。
虽然癌症幸存者吸烟和中度/重度饮酒的患病率较低，但他们的体育活动和健康 BMI 的患病率也较低，报告的睡眠时间也较长。回归分析表明，幸存者仅在饮酒方面表现出较差的行为。
需要针对癌症幸存者开展有针对性的健康促进干预措施。
