Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention in adolescent and young adult (AYA) cancer survivors: results from the SURVAYA study

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2024年1月15日

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Costanza Gavioli,
Carla Vlooswijk,
Silvie H. M. Janssen,
Suzanne E. J. Kaal,
J. Martijn Kerst,
Jacqueline M. Tromp,
Monique E. M. M. Bos,
Tom van der Hulle,
Winette T. A. van der Graaf,
Roy I. Lalisang,
Janine Nuver,
Rhodé M. Bijlsma,
Mathilde C. M. Kouwenhoven,
Olga Husson,
Sandra Beijer

摘要

Purpose

For adolescent and young adult (AYA) cancer survivors with a good prognosis, having a healthy lifestyle prevents morbidity and mortality after treatment. The aim of this study was to investigate the prevalence of (un)healthy lifestyle behaviors and related determinants in AYA cancer survivors.

Methods

A population-based, cross-sectional study was performed among long-term (5–20 years) AYA cancer survivors (18–39 years old at diagnosis) registered within the Netherlands Cancer Registry. Self-reported questionnaires data about health behaviors were used to calculate the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) adherence score. Associations between the score and clinical/sociodemographic determinants of (un)healthy behaviors were investigated using logistic regression models.

Results

The mean WCRF/AICR score was low to moderate, 3.8 ± 1.2 (0.5–7.0) (n = 3668). Sixty-one percent adhered to “limit the consumption of sugar sweetened drinks,” 28% to “be a healthy weight,” 25% to “fruit and vegetable consumption,” and 31% to “limit alcohol consumption.” Moderate and high adherence were associated with being a woman (OR_moderate = 1.46, 95% CI = 1.14–1.85, and OR_high = 1.87, 95% CI = 1.46–2.4) and highly educated (OR_moderate = 1.54, 95% CI = 1.30–1.83, and OR_high = 1.87, 95% CI = 1.46–2.4). Low adherence was associated with smoking (OR_moderate = 0.68, 95% CI = 0.50–0.92, and OR_high = 0.30, 95% CI = 0.21–0.44) and diagnosis of germ cell tumor (OR_moderate = 0.58, 95% CI = 0.39–0.86, and OR_high = 0.45, 95% CI = 0.30–0.69).

Conclusions

Adherence to the 2018 WCRF/AICR lifestyle recommendations was low to moderate, especially regarding body weight, fruit, vegetables, and alcohol consumption. Men, current smokers, lower-educated participants, and/or those diagnosed with germ cell tumors were less likely to have a healthy lifestyle.

Implications for Cancer Survivors

Health-promotion programs (e.g., age-specific tools) are needed, focusing on high-risk groups.