Top

Published in:

01-04-2016

Health behaviors, quality of life, and psychosocial health among survivors of adolescent and young adult cancers

Authors: Echo L. Warner, Gina E. Nam, Yingying Zhang, Molly McFadden, Jennifer Wright, Holly Spraker-Perlman, Anita Y. Kinney, Kevin C. Oeffinger, Anne C. Kirchhoff

Published in: Journal of Cancer Survivorship | Issue 2/2016

Abstract

Purpose

Survivors of adolescent and young adult (AYA) cancer may engage in unhealthy lifestyles (e.g., smoking), potentially heightening their risk for long-term health problems. We assessed health behaviors and constructs including quality of life (QOL) and psychosocial well-being among survivors of AYA cancer compared to the general population.

Methods

We used 2009 Behavioral Risk Factor Surveillance System data to evaluate health behaviors for survivors of AYA cancer compared to AYAs without cancer. Multivariable regressions assessed health behaviors (smoking, binge drinking, physical inactivity, and low fruit/vegetable intake) by sex and age between AYA survivors and controls, and among survivors to determine the effects of demographic, QOL, psychosocial, and cancer factors on behaviors.

Results

A greater proportion of female survivors of AYA cancer smoked than controls (currently aged 20–39: 27 vs. 14.3%, respectively; currently aged 40–64: 29.3 vs. 18.4%, respectively). Generally, survivors and controls were non-adherent to national health behavior guidelines. Uninsured survivors were at greater risk of smoking vs. insured (females, Relative Risk (RR) = 1.64, 95 % confidence interval (CI) 1.43–1.90; males, RR = 2.62, 95 % CI 1.71–4.02). Poor social/emotional support was associated with smoking (RR = 1.26, 95 % CI 1.07–1.48) among female survivors and was associated with low fruit/vegetable intake among male (RR = 1.12, 95 % CI 1.01–1.23) and female (RR = 1.12, 95 % CI 1.05–1.19) survivors. Female survivors >10 years from diagnosis had higher risk of smoking (RR = 1.26–1.91, all p < 0.01) than survivors 5–10 years from diagnosis.

Conclusions

Unhealthy lifestyle behaviors are common in survivors of AYA cancer.

Implications for Cancer Survivors

AYA survivors require health behavior support.

Available only for authorised users

Adolescent and Young Adult Oncology Progress Review Group. Closing the gap: research and care imperatives for adolescents and young adults with cancer. 2006; http://planning.cancer.gov/library/AYAO_PRG_Report_2006_FINAL.pdf. Accessed 5 June 2015.

Ries LAC, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Mariotto A et al. SEER Cancer Statistics Review, 1975–2005. National Cancer Institute, Bethesda, MD. 2008. http://seer.cancer.gov/csr/1975_2005/. Accessed 24 Sep 2014.

Arnett JJ. Emerging adulthood: a theory of development from the late teens through the twenties. Am Psychol. 2000;55(5):469–80.CrossRefPubMed

Maggs JL, Schulenberg J, Hurrelmann K. Developmental transitions during adolescence: health promotion implications. In: Schulenberg J, Maggs JL, Hurrelmann K, editors. Health risks and developmental transitions during adolescence. 1st ed. Cambridge: The Press Syndicate of the University of Cambridge; 1997. p. 522–46.

Tai E, Buchanan N, Townsend J, Fairley T, Moore A, Richardson LC. Health status of adolescent and young adult cancer survivors. Cancer. 2012;118(19):4884–91.CrossRefPubMed

Smith AW, Parsons HM, Kent EE, Bellizzi K, Zebrack BJ, Keel G, et al. Unmet support service needs and health-related quality of life among adolescents and young adults with cancer: the AYA HOPE Study. Front Oncol. 2013;3:75.CrossRefPubMedPubMedCentral

Coccia PF, Altman J, Bhatia S, Borinstein SC, Flynn J, George S, et al. Adolescent and young adult oncology. Clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2012;10(9):1112–50.PubMed

Wada RK, Glaser DW, Bantum EO, Orimoto T, Steffen AD, Elia JL, et al. Hawaii’s multiethnic adolescent and young adult survivors of childhood cancer: are their health behavior risks similar to state and national samples? Hawaii J Med Public Health. 2013;72(11):380–5.PubMedPubMedCentral

Fairley TL, Hawk H, Pierre S. Health behaviors and quality of life of cancer survivors in Massachusetts, 2006: data use for comprehensive cancer control. Prev Chronic Dis. 2010;7(1):A09.PubMedPubMedCentral

10.

Kirchhoff AC, Spraker-Perlman H, McFadden M, Warner EL, Oeffinger K, Wright J, et al. Sociodemographic disparities in quality of life for adolescent and young adult cancer survivors. J Adolesc Young Adult Oncol. 2014;3(2):66–74.CrossRefPubMedPubMedCentral

11.

Centers for Disease Control and Prevention. Behavioral risk factor surveillance system 2009 summary data quality report. 2011; http://www.cdc.gov/brfss/annual_data/2009/pdf/2009_summary_data_quality_report.pdf. Accessed 5 June 2015.

12.

Kapp JM, Jackson-Thompson J, Petroski GF, Schootman M. Reliability of health-related quality-of-life indicators in cancer survivors from a population-based sample, 2005. BRFSS Public Health. 2009;123(4):321–5.CrossRefPubMed

13.

Wechsler H, Dowdall GW, Davenport A, Rimm EB. A gender-specific measure of binge drinking among college students. Am J Public Health. 1995;85(7):982–5.CrossRefPubMedPubMedCentral

14.

Yore MM, Ham SA, Ainsworth BE, Kruger J, Reis JP, Kohl 3rd HW, et al. Reliability and validity of the instrument used in BRFSS to assess physical activity. Med Sci Sports Exerc. 2007;39(8):1267–74.CrossRefPubMed

15.

Children’s Oncology Group. Staying healthy through diet and physical activity. Long-term follow-up guidelines for survivors of childhood, adolescent, and young adult cancers. 2008; http://www.survivorshipguidelines.org/pdf/DietandPhysicalactivity.pdf. Accessed 5 June 2015.

16.

Centers for Disease Control and Prevention. 5 a day works! Department of Health and Human Services. 2005; http://www.cdc.gov/nccdphp/dnpa/nutrition/health_professionals/programs/5aday_works.pdf. Accessed 5 June 2015.

17.

Centers for Disease Control and Prevention. Measuring healthy days: population assessment of health-related quality of life. 2000; http://www.cdc.gov/hrqol/pdfs/mhd.pdf. Accessed 5 June 2015.

18.

Muller CJ, MacLehose RF. Estimating predicted probabilities from logistic regression: different methods correspond to different target populations. Int J Epidemiol. 2014;43(3):962–70.CrossRefPubMedPubMedCentral

19.

Heeringa SG, West BT, Berglund PA. Applied survey data analysis. New York: Chapman-Hall. 2010.

20.

Ford ES, Zhao G, Tsai J, Li C. Low-risk lifestyle behaviors and all-cause mortality: findings from the National Health and Nutrition Examination Survey Ill Mortality Study. Am J Public Health. 2011;101(10):1922–29.CrossRefPubMedPubMedCentral

21.

Rabin C, Politi M. Need for health behavior interventions for young adult cancer survivors. Am J Health Behav. 2010;34(1):70–6.

22.

Emmons KM, Puleo E, Park E, Gritz ER, Butterfield RM, Weeks JC, et al. Partnership for health-2, a web-based versus print smoking cessation intervention for childhood and young adult cancer survivors: randomized comparative effectiveness study. J Med Internet Res, 2013. 15(11): p. e218.

23.

Danesh D, Paskett ED, Ferketich AK. Disparities in receipt of advice to quit smoking from health care providers: 2010 National Health Interview Survey. Prev Chronic Dis. 2014;11:E131.CrossRefPubMedPubMedCentral

24.

Emmons KM, Sprunck-Harrild K, Puleo E, de Moor J. Provider advice about smoking cessation and pharmacotherapy among cancer survivors who smoke: practice guidelines are not translating. Transl Behav Med. 2013;3(2):211–7.CrossRefPubMedPubMedCentral

25.

Kaiser Family Foundation. Preventive services covered by private health plans under the Affordable Care Act. 2014; http://kff.org/health-reform/fact-sheet/preventive-services-covered-by-private-health-plans/. Accessed 7 Nov 2014.

26.

Phillips-Salimi CR, Lommel K, Andrykowski MA. Physical and mental health status and health behaviors of childhood cancer survivors: findings from the 2009 BRFSS survey. Pediatr Blood Cancer. 2012;58(6):964–70.CrossRefPubMedPubMedCentral

27.

Rabin C. Review of health behaviors and their correlates among young adult cancer survivors. J Behav Med. 2011;34(1):41–52.CrossRefPubMed

28.

Rabin C, Dunsiger S, Ness KK, Marcus BH. Internet-based physical activity intervention targeting young adult cancer survivors. J Adolesc Young Adult Oncol. 2011;1(4):188–94.CrossRefPubMedPubMedCentral

29.

Abrams AN, Hazen EP, Penson RT. Psychosocial issues in adolescents with cancer. Cancer Treat Rev. 2007;33(7):622–30.CrossRefPubMed

30.

Rabin C, Simpson N, Morrow K, Pinto B. Intervention format and delivery preferences among young adult cancer survivors. Int J Behav Med. 2013;20(2):304–10.CrossRefPubMed

31.

LeMasters TJ, Madhavan SS, Sambamoorthi U, Kurian S. Health behaviors among breast, prostate, and colorectal cancer survivors: a US population-based case-control study, with comparisons by cancer type and gender. J Cancer Surviv. 2014;8(3):336–48.CrossRefPubMed

32.

Coups EJ, Ostroff JS. A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med. 2005;40(6):702–11.CrossRefPubMed

33.

Schneider KL, Clark MA, Rakowski W, Lapane KL. Evaluating the impact of non-response bias in the Behavioral Risk Factor Surveillance System (BRFSS). J Epidemiol Community Health. 2012;66(4):290–5.CrossRefPubMed

34.

Blumberg S, Ganesh N, Luke J, Gonzales G. Wireless substitution: state-level estimates from the National Health Interview Survey, 2012. National Health Statistics Reports. 2013;70.

35.

Link MW, Battaglia MP, Frankel MR, Osborn L, Mokdad AH. Reaching the U.S. cell phone generation: comparison of cell phone survey results with an ongoing landline telephone survey. Public Opin Q. 2007;71(5):814–39.CrossRef

36.

Tucker C, Brick JM, Meekins B. Household telephone service and usage patterns in the United States in 2004: implications for telephone samples. Public Opin Q. 2007;71(1):3–22.CrossRef

37.

Underwood JM, Townsend JS, Stewart SL, Buchannan N, Ekwueme DU, Hawking NA. Surveillance of demographic characteristics and health behaviors among adult cancer survivors—behavioral risk factor surveillance system, United States, 2009. MMWR Morb Mortal Wkly Rep. 2012;61:1–23.

Title: Health behaviors, quality of life, and psychosocial health among survivors of adolescent and young adult cancers
Authors: Echo L. Warner
Gina E. Nam
Yingying Zhang
Molly McFadden
Jennifer Wright
Holly Spraker-Perlman
Anita Y. Kinney
Kevin C. Oeffinger
Anne C. Kirchhoff
Publication date: 01-04-2016
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 2/2016
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-015-0474-7

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Implications for Cancer Survivors

Please log in to get access to this content

Other articles of this Issue 2/2016

Engagement and experience with cancer-related follow-up care among young adult survivors of childhood cancer after transfer to adult care

The impact of having both cancer and diabetes on patient-reported outcomes: a systematic review and directions for future research

Factors associated with childhood cancer survivors’ knowledge about their diagnosis, treatment, and risk for late effects

The prevalence, severity, and correlates of psychological distress and impaired health-related quality of life following treatment for testicular cancer: a survivorship study

Adult survivors of childhood cancers’ identity disclosures in the workplace

Cancer survivorship services for indigenous peoples: where we stand, where to improve? A systematic review

Keynote webinar | Spotlight on antibody–drug conjugates in cancer