Health behaviors and cancer screening practices in long-term survivors of hematopoietic cell transplantation (HCT): a report from the BMT Survivor Study

Abstract

Patients undergoing hematopoietic cell transplantation (HCT) are at increased risk of chronic health conditions, including second malignant neoplasms and cardiovascular disease. Little is known about health behaviors and cancer screening practices among HCT survivors that could moderate the risk of these conditions. The BM transplant survivor study examined health behaviors and cancer screening practices in individuals who underwent HCT between 1976 and 1998, and survived 2+ years. Health behavior was deemed as high risk, if an individual was a current smoker and if they reported risky alcohol intake (≥4 drinks per day (males), ≥3 drinks per day (females)) on days of alcohol consumption. Cancer screening assessment was per American Cancer Society recommendations. There were 1040 survivors: 42.7% underwent allogeneic HCT; 43.8% were female; median time from HCT: 7.4 years (range 2.0-27.7 years). Median age at study participation: 43.8 years (range 18.3-73.0 years). Multivariate regression analysis revealed younger age (<35 years) at study participation (Odds ratio (OR)=4.7; P<0.01) and lower education (<college: OR=2.1; P<0.01) to be significantly associated with high-risk behavior. Survivors were significantly less likely to report high-risk behavior (OR=0.5; P<0.01) and more likely to have had a screening mammogram (OR=2.8; P=0.05) when compared with gender-matched sibling controls (N=309).

Figure 1

Reported breast cancer screening among HCT survivors (with and without chest radiation exposure) and siblings.