World Journal of Epidemiology and Cancer Prevention Volume No 8

Research Open Access

Determinants of Unhealthy Behaviors among Adult Cancer Survivors

Salman Salaria, Ahsan Y Khan and Norma Kanarek
World Journal of Epidemiology and Cancer Prevention 2015, 4:3



To evaluate the impact of time since cancer diagnosis, access to health care, and demographics in the prevalence of cancer six unhealthy behaviors (lack of exercise, overweight, inadequate sleep, less life satisfaction, current smoking and alcohol use) among cancer survivors.


Maryland Behavioral Risk Factor Surveillance System (BRFSS) participants, who reported in 2009 a previous history of cancer were included in this study. With the exception of non-melanoma skin cancers all cancer sites were included. Logistic regression assessed time since cancer diagnosis, access to health care and demographics as predictors of unhealthy behaviors.


Unhealthy behaviors were differentially predicted. Time since cancer diagnosis was not significant for any unhealthy behaviors after multivariate adjustment. Access to health care has significant impact on sleep and life satisfaction. Female gender was significant for weight gain. Current smoking, alcohol use, and lack of exercise were affected by place of residence. Most striking were large and statistically significant high ORs for current smoking in all local Maryland jurisdictions compared to Montgomery County.


Contrary to our hypothesis, cancer survivors did not participate more in healthy behaviors with increasing time since cancer diagnosis. We expected health care access to play a critical role in advising cancer survivors to adopt healthy behaviors. However, this was true for only two of the six unhealthy behaviors. This study increases awareness about Maryland adult cancer survivors, and may motivate a renewed prevention mindset for physicians towards their cancer survivor patients as well as patients with cancer.

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