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
. 2025 Jan 9;25(1):50.
doi: 10.1186/s12885-024-13373-5.

Cancer-related health behaviors during the COVID 19 pandemic in geographically diverse samples across the US

Breanna B Greteman  1 , Allison Cole  2 , Mary E Charlton  3 , Jackilen Shannon  4 , Deanna Kepka  5 , Electra D Paskett  6 , Evelinn A Borrayo  7 , Jamie L Studts  7 , Hayley S Thompson  8 , Isabel Scarinci  9 , Lynn Chollet Hinton  10 , Elizabeth A Chrischilles  1 , Crystal J Garcia-Auguste  1 , Kaila Christini  5 , Heather Aker  6 , Jesse J Plascak  6 , Felicity W K Harper  8 , Monica L Baskin  9 , Sejong Bae  9 , Vishruti Pandya  9 , Young-Il Kim  9 , Babalola Faseru  10 , Christie Befort  10 , Hanluen Kuo  10 , Mark Dignan  11 , Juan Canedo  11 , Victoria Champion  12 , Bettina F Drake  13 , Kia L Davis  13 , Debra L Friedman  14 , Mohamed I Elsaid  15 , Scherezade K Mama  16 , Wendy F Cohn  17
Affiliations

Cancer-related health behaviors during the COVID 19 pandemic in geographically diverse samples across the US

Breanna B Greteman et al. BMC Cancer. .

Abstract

Background: The COVID-19 pandemic involved business closures (e.g., gyms), social distancing policies, and prolonged stressful situations that may have impacted engagement in health behaviors. Our study assessed changes in cancer-related health behaviors during the pandemic, specifically physical activity, fruit/vegetable intake, smoking/tobacco use, and alcohol consumption.

Methods: Eight cancer centers administered mailed/web-based/telephone surveys between June 2020 and March 2021. Surveys assessed demographics, perceptions on social distancing, and self-reported changes of behaviors (less/same/more) associated with cancer prevention or risk, e.g., physical activity, fruit/vegetable intake, tobacco/smoking use, and alcohol consumption. Descriptive analyses and logistic regression models assessed association of variables with behavior change.

Results: Most of the 21,911 respondents reported adhering to at least 4(of 5) social distancing measures (72%) and indicated social distancing was very/somewhat important to prevent the spread of COVID-19 (91%). 35% of respondents reported less physical activity, 11% reported less fruit/vegetable intake, 27% reported more smoking/tobacco use (among those who used tobacco/smoking products in past 30 days), and 23% reported more alcohol consumption (among those who reported at least 1 drink in past 30 days) than before the pandemic. Urban residence, younger age, female gender, and worse general health were associated with less physical activity, less fruit/vegetable intake, more smoking/tobacco use, and more alcohol intake. Higher educational attainment was associated with less physical activity and fruit/vegetable intake and more alcohol consumption. Reporting social distancing as important and adhering to more COVID-19 safety practices were associated with less physical activity and more alcohol consumption.

Conclusion: Our findings suggest that certain demographics and those who adhered to social distancing measures were more likely to self-report unfavorable changes in health behaviors during the pandemic. Future studies should examine if the behaviors returned to baseline following relief from pandemic restrictions, and if these behavior changes are associated with increased cancer incidence and mortality.

Keywords: Behaviors; COVID-19; Cancer; Health; Prevention.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Written informed consent was obtained from all participants via an informed consent document included in survey packets. The informed consent document explained the purpose of the survey, how the data will be stored and analyzed, that their de-identified data may be analyzed for publication, and any benefits and risks associated with survey participation. Research was performed in accordance with the Declaration of Helsinki. Institutional Review Board (IRB) approval for this study was received from each individual site. The following sites were approved after full IRB review: Colorado Multiple IRB (Study ID PAM020-2), and Vanderbilt IRB (IRB #190235). To note, Colorado’s survey was conducted as an extension of an existing survey; thus, the approval for Colorado’s added COVID survey is shown as an amendment. The following sites received expedited review or were ruled exempt from full IRB review: University of Iowa (#IRB00000099), University of Virginia IRB for Health Sciences Research (IRB-HSR #22747), Wayne State University IRB (IRB #20-05-2219-B3), University of Alabama at Birmingham IRB (IRB #00000196/#00000726), Oregon Health & Science University IRB (IRB #300002135), and Ohio State University Cancer IRB (Study #2020C0081). Data use agreements were obtained from each site to transmit de-identified data to the coordinating center at the University of Alabama at Birmingham (UAB). Consent for publication: Written consent was received via an informed consent document included in survey packets. The informed consent document explained the purpose of the survey, how the data will be stored and analyzed, that their de-identified data may be analyzed for publication, and any benefits and risks associated with survey participation. Competing interests: Deanna Kepka is the Principal Investigator of two Merck Investigator Studies Program (MISP) Awards to Huntsman Cancer Institute at the University of Utah. Electra Paskett is the MPI on grants to the institution from Merck Foundation, Pfizer, Genentech, and Guardant Health and is an advisor for Glaxo Smith Kline. Jamie Studts provides consultation to Genentech and the J&J Lung Cancer Initiative. Monica Baskin is an advisor to Janssen Global Services, LLC; none are related to this work. The rest of the authors (BBG, AC, MEC, JS, EAB, HT, IS, LCH, EAC, CJGA, KC, HA, JJP, FWKH, SB, VP, YK, BF, CB, HK, MD, JC, VC, BFD, KLD, DLF, MIE, SKM, and WFC) declare they have no competing interest(s).

Similar articles

See all similar articles

References

    1. World Health Organization: WHO Coronavirus (COVID-19) Dashboard. (2023). https://data.who.int/dashboards/covid19/cases?n=c. Accessed July 1, 2023.
    1. Gostin LO, Wiley LF. Governmental Public Health Powers during the COVID-19 pandemic: stay-at-home orders, Business closures, and travel restrictions. JAMA. 2020;323(21):2137–8. 10.1001/jama.2020.5460. - PubMed
    1. Haffajee RL, Mello MM. Thinking globally, acting locally - the U.S. response to Covid-19. N Engl J Med. 2020;382(22):e75. 10.1056/NEJMp2006740. - PubMed
    1. Mazidimoradi A, Tiznobaik A, Salehiniya H. Impact of the COVID-19 pandemic on Colorectal Cancer Screening: a systematic review. J Gastrointest Cancer. 2022;53(3):730–44. 10.1007/s12029-021-00679-x. - PMC - PubMed
    1. de Joode K, Dumoulin DW, Engelen V, Bloemendal HJ, Verheij M, van Laarhoven HWM, et al. Impact of the coronavirus disease 2019 pandemic on cancer treatment: the patients’ perspective. Eur J Cancer. 2020;136:132–9. 10.1016/j.ejca.2020.06.019. - PMC - PubMed