Is a cancer diagnosis a trigger for health behaviour change? Findings from a prospective, population-based study

Abstract

Background: A healthy lifestyle following a cancer diagnosis may improve long-term outcomes. No studies have examined health behaviour change among U.K. cancer survivors, or tracked behaviours over time in survivors and controls. We assessed smoking, alcohol and physical activity at three times (0-2 years before a cancer diagnosis, 0-2 years post-diagnosis and 2-4 years post-diagnosis) and at matched times in a comparison group.

Methods: Data were from waves 1-5 of the English Longitudinal Study of Ageing; a cohort of older adults in England. Behavioural measures were taken at each wave. Generalised estimating equations were used to examine differences by group and time, and group-by-time interactions.

Results: Of the 5146 adults included in the analyses, 433 (8.4%) were diagnosed with cancer. Those with a cancer diagnosis were less likely to be physically active (P<0.01) and more likely to be sedentary (P<0.001). There were no group differences in alcohol or smoking. Smoking, alcohol and activity reduced over time in the whole group. Group-by-time interactions were not significant for smoking (P=0.17), alcohol (P=0.20), activity (P=0.17) or sedentary behaviour (P=0.86), although there were trends towards a transient improvement from pre-diagnosis to immediately post-diagnosis.

Conclusion: We found little evidence that a cancer diagnosis motivates health-protective changes. Given the importance of healthy lifestyles, strategies for effective support for behaviour change in cancer survivors need to be identified.

Figure 1

The proportion of each group who smoked at each time point (adjusted for age, sex and wealth).

Figure 2

The proportion of each group who drank alcohol daily at each time point (adjusted for age, sex and wealth).

Figure 3

The proportion of each group who were moderately or vigorously active ≥1 per week at each time point (adjusted for age, sex and wealth).

Figure 4

The proportion of each group who were sedentary at each time point (adjusted for age, sex and wealth).