Unhealthy Behaviors More Prevalent in Survivors of Multiple Cancers, Study Shows

A study published by University of Kentucky researchers shows that survivors of multiple cancers report unhealthier behaviors post-diagnosis than control counterparts.

Published in the Annals of Behavioral Medicine, the study recorded answers regarding health status and health behaviors from 404,525 adults using the Behavioral Risk Factor Surveillance System survey. Participants who said they had never received a diagnosis of cancer from a health professional were considered controls, while those who answered "yes" were considered cancer survivors. Those who had received two or more cancer diagnoses were considered a survivor of multiple cancers.

The study showed that survivors of multiple cancers reported a poorer physical and mental health status compared to survivors of a single cancer, who in turn reported a poorer overall health status relative to the control group.

Survivors of multiple cancers showed a greater likelihood of cigarette smoking or smokeless tobacco use, greater alcohol consumption when drinking, and less moderate and vigorous physical activity.

Researchers suggest that the prolonged, heightened stress of multiple cancer diagnoses may increase a patient's "allostatic load," the natural wear and tear that occurs in the body due to experiencing stress. This data indicates that patients who have survived multiple cancers need clinical interventions to enhance both physical and mental health status and to help patients adopt healthier behaviors.

Cancer patients have a 20% higher risk of new primary cancer compared with the general population. Approximately one third of cancer survivors aged >60 years were diagnosed more than once with another cancer. As the number of cancer survivors and of older people increases, occurrence of multiple primary cancers is also likely to increase. An increasing interest from epidemiologic and clinical perspectives seems logical. This chapter begins with the risk pattern of multiple cancers in the population of a developed country with high survival rates. Multiple cancers comprise two or more primary cancers occurring in an individual that originate in a primary site or tissue and that are neither an extension, nor a recurrence or metastasis. Studies of multiple cancers have been mainly conducted in population-based settings, and more recently in clinical trials and case control studies leading to further understanding of risk factors for the development of multiple primary cancers. These factors include an inherited predisposition to cancer; the usual carcinogenic or cancer-promoting aspects of lifestyle, hormonal, and environmental factors; treatment of the previous primary cancer; and increased surveillance of cancer survivors. Finally, implication on research strategies and clinical practice are discussed, covering the whole range of epidemiologic approach.

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Soerjomataram I, Coebergh JW.