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人口统计学和癌症特异性因素与儿童癌症幸存者特定于癌症预防和控制的健康行为建议之间的关联。

Association of Demographic and Cancer-Specific Factors on Health Behavior Recommendations Specific to Cancer Prevention and Control Among Adolescent and Young Adult Survivors of Childhood Cancer.

机构信息

The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

J Adolesc Young Adult Oncol. 2021 Dec;10(6):619-628. doi: 10.1089/jayao.2020.0130. Epub 2020 Nov 18.

Abstract

Adolescent and young adult survivors of childhood cancer (AYA) are at risk for long-term health problems that are exacerbated by not meeting health behavior recommendations (e.g., exercise). To identify AYA at risk for not meeting health behavior recommendations, we explored demographic (e.g., age) and cancer-specific (e.g., intensity of treatment) factors associated with not meeting specific health behavior recommendations that have implications for cancer prevention and control. Regression (linear/binary) was used to examine demographic and cancer-specific associates regarding fruit/vegetable intake, binge drinking, sleep duration, sunscreen use, tobacco use, and physical activity among 307 AYA (M = 20.33, range = 15-34) across three combined studies, treated at a pediatric cancer center. Health behavior measures were adapted from The Health Behaviors Survey and the Youth Risk Behavior Surveillance System questionnaire. AYA in general did not meet health behavior recommendations. Compared with AYA with public insurance, AYA with private insurance ( = -0.19,  < 0.01) were more likely to meet multiple health behavior recommendations. AYA at greatest risk for not meeting specific health behaviors were more likely to be diagnosed in middle childhood (11.35) compared with early childhood (8.38), be closer to diagnosis (8.77 vs. 11.76) and closer to treatment completion (6.97 vs. 9.91), and have a solid tumor (32.7%) compared with a brain tumor (10.6%). Not meeting health behavior recommendations is common among AYA survivors of childhood cancer. Early education in the context of survivorship care is critical to provide teachable moments to AYA; such interventions might impact future long-term health and reduce risk for secondary cancers.

摘要

儿童癌症幸存者中的青少年和年轻成年人(AYA)存在长期健康问题的风险,这些问题因未达到健康行为建议(例如运动)而加剧。为了确定不符合健康行为建议的 AYA,我们探讨了与不符合特定健康行为建议相关的人口统计学(例如年龄)和癌症特异性(例如治疗强度)因素,这些建议对癌症预防和控制具有重要意义。 我们使用回归(线性/二项式)分析了来自三个合并研究的 307 名 AYA(M = 20.33,范围 = 15-34)的人口统计学和癌症特异性因素,这些 AYA 在儿科癌症中心接受治疗。健康行为测量方法改编自《健康行为调查》和《青年风险行为监测系统问卷》。 AYA 总体上不符合健康行为建议。与拥有公共保险的 AYA 相比,拥有私人保险的 AYA( = -0.19,  < 0.01)更有可能符合多项健康行为建议。最不符合特定健康行为的 AYA 更有可能在童年中期(11.35)而不是在童年早期(8.38)被诊断出来,更接近诊断(8.77 比 11.76)和更接近治疗完成(6.97 比 9.91),并且患有实体瘤(32.7%)而不是脑肿瘤(10.6%)。 不符合健康行为建议在儿童癌症幸存者中的 AYA 中很常见。在生存护理的背景下进行早期教育对于 AYA 至关重要,这提供了教育的机会;这种干预措施可能会影响未来的长期健康并降低继发癌症的风险。

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