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. 2024 Oct 1;47(10):485-495.
doi: 10.1097/COC.0000000000001123. Epub 2024 Jun 24.

Modifiable Lifestyle Risk Factors in Adult Survivors of Childhood Cancer: A Nationally Representative Study

Minh D Ton  1 , Jeffrey Shi Kai Chan  2 , Danish Iltaf Satti  3   4 , Erin C Peckham-Gregory  5   6   7 , Brandon A Mahal  1 , Derek Isrow  1 , Edward Christopher Dee  8 , Nishwant S Swami  9
Affiliations

Modifiable Lifestyle Risk Factors in Adult Survivors of Childhood Cancer: A Nationally Representative Study

Minh D Ton et al. Am J Clin Oncol. .

Abstract

Objectives: Given the vulnerable health condition of adult childhood cancer survivors, it is essential that they develop positive health behaviors to minimize controllable health risks. Therefore, we evaluated if adult survivors of non-childhood cancer and childhood cancer differ in the odds of each modifiable risk factor compared with each other and compared with the general population.

Methods: This nationally representative study leveraged the National Health Interview Survey (NHIS) sample from 2000 to 2018 and the Behavioral Risk Factor Surveillance System (BRFSS) sample from 2016 to 2021. Our study population included adults diagnosed with cancer when they were ≤14 years of age. Outcomes included physical activity, body mass index (BMI), current smoking, ever-smoking, alcohol use, and binge drinking.

Results: Insufficient physical activity was not statistically significant in the BRFSS, but in the NHIS, childhood cancer survivors had significantly more insufficient physical activity compared with non-childhood cancer survivors (aOR 1.29, P =0.038) and the general population (aOR 1.40, P =0.006). Childhood cancer survivors also had a higher likelihood of being significantly underweight (aOR 1.84, P =0.018) and having ever-smoked (aOR 1.42, P =0.001) compared with the general population in the NHIS. There was a significantly higher likelihood of smoking among childhood cancer survivors in the BRFSS (aOR 2.02, P =0.004).

Conclusions: The likelihoods of many risky behaviors between adult childhood cancer survivors and general population controls were comparable, although rates of physical activity may be decreased, and rates of smoking may be increased among childhood cancer survivors. Targeted interventions are needed to promote healthy behaviors in this vulnerable population.

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Conflict of interest statement

The funder did not play a role in the design of the study; the collection, analysis, and interpretation of the data; the writing of the manuscript; and the decision to submit the manuscript for publication. No pharmaceutical company or other agency has paid any author to write this article, and the authors have no conflicts of interest relevant to this article to disclose. The content of this paper has not been published in a journal. The authors declare no conflicts of interest.

Figures

Fig. 1A
Fig. 1A
Modifiable lifestyle risk factors among adult survivors of childhood cancers, adult survivors of non-childhood cancers, and adults without a history of cancer in the 2000–2018 NHIS sample. Percentages of adult survivors of childhood cancer engaging in risky health behaviors in blue are compared to the percentage of adult survivors of non-childhood cancers and adults without a history of cancer engaging in risky health behaviors in orange.
Fig. 1B
Fig. 1B
Modifiable lifestyle risk factors among adult survivors of childhood cancers, adult survivors of non-childhood cancers, and adults without a history of cancer in the 2016–2021 BRFSS sample. Percentages of adult survivors of childhood cancer engaging in risky health behaviors in blue are compared to the percentage of adult survivors of non-childhood cancers and adults without a history of cancer engaging in risky health behaviors in orange.
See this image and copyright information in PMC

References

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