Purpose <p>Childhood cancer survivors are at risk of late effects. Engaging in health behaviours may reduce this risk. We aimed to investigate engagement in risky (alcohol consumption, smoking), protective (sun protection, physical activity, dental hygiene), and screening (cervical screening, skin examinations) behaviours between survivors and an age- and sex-matched control group.</p> Methods <p>We conducted a cross-sectional survey in childhood cancer survivors (aged 16 + years) who were 5 + years post-diagnosis, proxy report of parents of survivors (aged &lt; 16&#xa0;years) and age- and sex-matched non-cancer controls. We compared survivor responses to the Children’s Oncology Group Long-Term Follow-Up Guidelines.</p> Results <p>612 survivors (median age = 19, range = 7–61; 49% male) and 423 controls (median = 21, range = 0–45; 51.5% male) were included in our analysis. Survivors were more likely to smoke less (<i>p</i> &lt; .001), floss less (<i>p</i> &lt; .05), use sunscreen (<i>p</i> &lt; .001), wear protective clothing (<i>p</i> &lt; .001), stay in the shade less (<i>p</i> &lt; .01), and engage in skin examinations (<i>p</i> &lt; .001), compared to controls. Most survivors met alcohol (72%), smoking (93%) and sunscreen (66%) guidelines. Fewer survivors met guidelines for physical activity (31%), flossing (4%), wearing a hat for sun protection (40%), skin examinations (40%) and cervical screening (43%). Survivors who were older age, female sex and had higher income were associated with meeting all health behaviour guidelines.</p> Conclusions <p>Many survivors do not meet protective and screening behaviour recommended guidelines.</p> Implications for Cancer Survivors <p>Engagement in multiple positive health behaviours is critical for this population who are at increased risk of developing long-term health issues.</p>