Radboud University Medical Center, Nijmegen, The Netherlands.
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Cancer. 2024 Aug 15;130(16):2856-2872. doi: 10.1002/cncr.35338. Epub 2024 Apr 25.
The objective of this study was to examine the prevalence of unhealthy lifestyle behaviors, overweight, and obesity in Dutch childhood cancer survivors (CCSs) compared with sibling controls and the Dutch general population. Other aims were to assess associated factors of unhealthy lifestyle behaviors, overweight, and obesity and to identify subgroups of CCSs at risk for these unhealthy statuses.
The authors included 2253 CCSs and 906 siblings from the Dutch Childhood Cancer Survivor Study-Late Effects After Childhood Cancer cohort, part 1, and added data from the Dutch general population. Questionnaire data were collected on overweight and obesity (body mass index >25.0 kg/m), meeting physical activity guidelines (>150 minutes per week of moderate or vigorous exercises), excessive alcohol consumption (>14 and >21 alcoholic consumptions per week for women and men, respectively), daily smoking, and monthly drug use. Multivariable logistic regression analyses and two-step cluster analyses were performed to examine sociodemographic-related, health-related, cancer-related, and treatment-related associated factors of unhealthy lifestyle behaviors and to identify subgroups of CCSs at risk for multiple unhealthy behaviors.
CCSs more often did not meet physical activity guidelines than their siblings (30.0% vs. 19.3%; p < .001). Married as marital status, lower education level, nonstudent status, and comorbidities were common associated factors for a body mass index ≥25.0 kg/m and insufficient physical activity, whereas male sex and lower education were shared associated factors for excessive alcohol consumption, daily smoking, and monthly drug use. A subgroup of CCSs was identified as excessive alcohol consumers, daily smokers, and monthly drug users.
The current results emphasize the factors associated with unhealthy behaviors and the potential identification of CCSs who exhibit multiple unhealthy lifestyle behaviors.
本研究旨在调查荷兰儿童癌症幸存者（CCS）与同胞对照和荷兰普通人群相比，不健康生活方式行为、超重和肥胖的流行情况。其他目的是评估不健康生活方式行为、超重和肥胖的相关因素，并确定存在这些不健康状况风险的 CCS 亚组。
作者纳入了来自荷兰儿童癌症幸存者研究-儿童癌症后长期影响第 1 部分的 2253 名 CCS 和 906 名同胞，并添加了来自荷兰普通人群的数据。使用问卷调查超重和肥胖（体重指数>25.0kg/m2）、达到体力活动指南（每周>150 分钟中等强度或剧烈运动）、过量饮酒（女性和男性分别>14 和>21 个酒精摄入量）、每日吸烟和每月使用药物情况。采用多变量逻辑回归分析和两步聚类分析，以检查与社会人口统计学、健康相关、癌症相关和治疗相关的不健康生活方式行为的相关因素，并确定存在多种不健康行为风险的 CCS 亚组。
与同胞相比，CCS 不符合体力活动指南的比例更高（30.0%比 19.3%；p<0.001）。已婚作为婚姻状况、较低的教育水平、非学生身份和合并症是体重指数≥25.0kg/m2和体力活动不足的常见相关因素，而男性和较低的教育水平是过量饮酒、每日吸烟和每月使用药物的共同相关因素。确定了一个 CCS 亚组，其为过量饮酒者、每日吸烟者和每月药物使用者。
目前的结果强调了与不健康行为相关的因素，以及识别存在多种不健康生活方式行为的 CCS 的潜力。
