Clustering of health behaviours in adult survivors of childhood cancer and the general population

Abstract

Background: Little is known about engagement in multiple health behaviours in childhood cancer survivors.

Methods: Using latent class analysis, we identified health behaviour patterns in 835 adult survivors of childhood cancer (age 20-35 years) and 1670 age- and sex-matched controls from the general population. Behaviour groups were determined from replies to questions on smoking, drinking, cannabis use, sporting activities, diet, sun protection and skin examination.

Results: The model identified four health behaviour patterns: 'risk-avoidance', with a generally healthy behaviour; 'moderate drinking', with higher levels of sporting activities, but moderate alcohol-consumption; 'risk-taking', engaging in several risk behaviours; and 'smoking', smoking but not drinking. Similar proportions of survivors and controls fell into the 'risk-avoiding' (42% vs 44%) and the 'risk-taking' cluster (14% vs 12%), but more survivors were in the 'moderate drinking' (39% vs 28%) and fewer in the 'smoking' cluster (5% vs 16%). Determinants of health behaviour clusters were gender, migration background, income and therapy.

Conclusion: A comparable proportion of childhood cancer survivors as in the general population engage in multiple health-compromising behaviours. Because of increased vulnerability of survivors, multiple risk behaviours should be addressed in targeted health interventions.

Figure 1

Illustration of behaviour groups identified by LCA as the number of classes was increased. The boxes in a given layer represent the behaviour groups identified in that model. Numbers of individuals and percentage of sample allocated to the group are reported next to the boxes.

Figure 2

Prevalence of health behaviours within the four health-behaviour patterns identified. The prevalence of the response categories of a given variable are connected with lines to better visualise differences between the behaviour patterns. , Cluster D1: risk-avaiding;, Cluster D2: moderate drinking;, Cluster D3: risk-taking;, Cluster D4: smoking. Abbreviations: v=vegetables; f=fruits.