Kreiberg Michael, Bandak Mikkel, Lauritsen Jakob, Wagner Thomas, Rosenvilde Josephine, Agerbaek Mads, Dysager Lars, Lau Cathrine Juel, Andersen Klaus Kaae, Daugaard Gedske
Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Acta Oncol. 2021 Mar;60(3):361-369. doi: 10.1080/0284186X.2020.1851765. Epub 2020 Dec 1.
Treatment for disseminated testicular cancer increases the risk of secondary malignancy and cardiovascular disease. The risk of developing these serious adverse effects may be positively affected by healthy living. The purpose of this study was to identify health behaviours with possible influence on late effects that could be targets for intervention.
In this cross-sectional study, testicular cancer survivors diagnosed in the period 1984-2007 from the Danish Testicular Cancer database completed a questionnaire on health behaviours (2014-2016). We estimated prevalence of smoking, alcohol consumption, sedentary lifestyle and overweight. Prevalence ratios described with 95% confidence intervals of adverse health behaviours were stratified by treatment modalities and compared to a reference population by means of logistic regression with adjustment for sociodemographic confounders.
In total, 2395 testicular cancer survivors (surveillance, 1175; chemotherapy, 897; radiotherapy, 323), median time since diagnosis 19 years, and 65,289 noncancer males were included, questionnaire response rates were 60% and 54%, respectively. There were more current smokers (prevalence ratio; 1.14, 95% confidence interval (CI): 1.03-1.26) and patients with body mass index above 25 kg/m (prevalence ratio; 1.10, 95% CI: 1.01-1.20) among testicular cancer survivors than in the reference population. Testicular cancer survivors reported less sedentary lifestyle (prevalence ratio; 95% CI: 0.74, 0.64-0.85) and everyday drinkers were fewer (prevalence ratio; 0.79, 95% CI: 0.68-0.92) than in the reference population.
We identified smoking cessation as primary target for intervention studies in testicular cancer survivors. The effect of smoking cessation interventions as part of treatment should be investigated. Whether drug-based intervention is effective in minimising the risk of exposure to conventional risk factors for cardiovascular disease is also of interest.
播散性睾丸癌的治疗会增加继发恶性肿瘤和心血管疾病的风险。健康的生活方式可能会对发生这些严重不良反应的风险产生积极影响。本研究的目的是确定可能对远期效应有影响的健康行为，这些行为可作为干预目标。
在这项横断面研究中，从丹麦睾丸癌数据库选取1984年至2007年期间确诊的睾丸癌幸存者，于2014年至2016年完成一份关于健康行为的问卷。我们估算了吸烟、饮酒、久坐不动的生活方式和超重的患病率。按治疗方式对不良健康行为的患病率比值及95%置信区间进行分层，并通过逻辑回归对社会人口学混杂因素进行调整后，与参照人群进行比较。
总共纳入了2395名睾丸癌幸存者（监测组1175人；化疗组897人；放疗组323人），自确诊后的中位时间为19年，以及65289名非癌症男性，问卷回复率分别为60%和54%。与参照人群相比，睾丸癌幸存者中当前吸烟者更多（患病率比值：1.14，95%置信区间(CI)：1.03 - 1.26），体重指数高于25kg/m²的患者更多（患病率比值：1.10，95%CI：1.01 - 1.20）。与参照人群相比，睾丸癌幸存者报告的久坐不动生活方式较少（患病率比值；95%CI：0.74，0.64 - 0.85），每日饮酒者较少（患病率比值；0.79，95%CI：0.68 - 0.92）。
我们确定戒烟是睾丸癌幸存者干预研究的首要目标。应研究将戒烟干预作为治疗一部分的效果。基于药物的干预在将心血管疾病传统风险因素暴露风险降至最低方面是否有效也值得关注。
