Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Apr 20;27(12):1969-75.
doi: 10.1200/JCO.2008.18.2188. Epub 2009 Mar 16.

Pretreatment health behaviors predict survival among patients with head and neck squamous cell carcinoma

Sonia A Duffy  1 , David L Ronis, Scott McLean, Karen E Fowler, Stephen B Gruber, Gregory T Wolf, Jeffrey E Terrell
Affiliations

Pretreatment health behaviors predict survival among patients with head and neck squamous cell carcinoma

Sonia A Duffy et al. J Clin Oncol. .

Abstract

Purpose: Our prior work has shown that the health behaviors of head and neck cancer patients are interrelated and are associated with quality of life; however, other than smoking, the relationship between health behaviors and survival is unclear.

Patients and methods: A prospective cohort study was conducted to determine the relationship between five pretreatment health behaviors (smoking, alcohol, diet, physical activity, and sleep) and all-cause survival among 504 head and neck cancer patients.

Results: Smoking status was the strongest predictor of survival, with both current smokers (hazard ratio [HR] = 2.4; 95% CI, 1.3 to 4.4) and former smokers (HR = 2.0; 95% CI, 1.2 to 3.5) showing significant associations with poor survival. Problem drinking was associated with survival in the univariate analysis (HR = 1.4; 95% CI, 1.0 to 2.0) but lost significance when controlling for other factors. Low fruit intake was negatively associated with survival in the univariate analysis only (HR = 1.6; 95% CI, 1.1 to 2.1), whereas vegetable intake was not significant in either univariate or multivariate analyses. Although physical activity was associated with survival in the univariate analysis (HR = 0.95; 95% CI, 0.93 to 0.97), it was not significant in the multivariate model. Sleep was not significantly associated with survival in either univariate or multivariate analysis. Control variables that were also independently associated with survival in the multivariate analysis were age, education, tumor site, cancer stage, and surgical treatment.

Conclusion: Variation in selected pretreatment health behaviors (eg, smoking, fruit intake, and physical activity) in this population is associated with variation in survival.

PubMed Disclaimer

Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Kaplan-Meier plots of survival for health behaviors of head and neck cancer patients. (A) Smoking status (n = 712; 260 events and 452 patients censored). (B) Alcohol problem (Alcohol Use Disorders Identification Test ≥ 8; n = 689; 248 events and 441 patients censored). (C) Average prediagnosis fruit intake (n = 520; 175 events and 345 patients censored). (D) Average prediagnosis vegetable intake (n = 544; 184 events and 360 patients censored). (E) Physical Activity Scale for the Elderly score by quartile (n = 625; 223 events and 402 patients censored). (F) Medical Outcomes Study sleep scale by quartile (n = 621; 220 events and 401 patients censored).
See this image and copyright information in PMC

Comment in

  • Health behaviors influence cancer survival.
    Gritz ER, Demark-Wahnefried W. Gritz ER, et al. J Clin Oncol. 2009 Apr 20;27(12):1930-2. doi: 10.1200/JCO.2008.21.3769. Epub 2009 Mar 16. J Clin Oncol. 2009. PMID: 19289610 No abstract available.

References

    1. Hoffman HT, Karnell LH, Funk GF, et al. The National Cancer Data Base report on cancer of the head and neck. Arch Otolaryngol Head Neck Surg. 1998;124:951–962. - PubMed
    1. Ries LAG, Harkins D, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2003. Bethesda, MD: National Cancer Institute; 2006.
    1. Duffy SA, Terrell JE, Valenstein M, et al. Effect of smoking, alcohol, and depression on the quality of life of head and neck cancer patients. Gen Hosp Psychiatry. 2002;24:140–147. - PubMed
    1. Gritz ER, Carmack CL, de Moor C, et al. First year after head and neck cancer: Quality of life. J Clin Oncol. 1999;17:352–360. - PubMed
    1. Dikshit RP, Boffetta P, Bouchardy C, et al. Lifestyle habits as prognostic factors in survival of laryngeal and hypopharyngeal cancer: A multicentric European study. Int J Cancer. 2005;117:992–995. - PubMed

Publication types

MeSH terms