Health Risk Behaviors of Young Adult Cancer Survivors As They Age into Middle and Late Adulthood: A Comparison with a Never-Cancer Cohort

Abstract

Background

Social scientists are placing increased attention on the long-term health needs of young adult cancer survivors and their risk for secondary malignancies and toxicities from chemotherapy and radiation. Research into the patterns of health behaviors of young adult cancer survivors as they age into middle adulthood and late adulthood can assist social workers and health promoters in developing interventions aimed at promoting healthy survivorship.

Method

Responses from 253,547 non-institutionalized adults, aged 35 and older, from the 2014 version of the Behavioral Risk Factor Surveillance System (BRFSS) were analyzed to discover relationships between demographic variables (age, sex, race/ethnicity, income, education, and marital status), health risk behaviors (current smoking, inadequate sleep, heavy drinking, and inactivity) and an individual’s cancer survivorship status. Logistic regression analyses were performed to determine associations between survivor status and each health risk behavior, and within the cancer survivor sample to determine factors associated with survivor’s participation in health risk behaviors. Cross tabulations were performed to investigate patterns of health risk behaviors in middle and late adulthood for YACS versus their never-cancer cohort.

Results

The analysis produced a sample of 381 cancer survivors and 253,547 individuals in the never-cancer cohort. Both samples were mostly female, White, in their middle adult years, married or cohabitating, had annual incomes over $50,000 and some college education. Approximately one-third of YACS reported participation in health risk behaviors except for heavy drinking.

            Logistic regression analyses between the two sample populations revealed that the never-cancer cohort were less likely to smoke than YACS (AOR=.484, 95% CI = .360-.649) and the never-cancer cohort was more likely than the YACS cohort to have inadequate sleep (AOR=1.743, 95% CI= 1.333-2.280). The analysis of the YACS found significant relationships between cigarette smoking and inadequate sleep and several socio-demographic controls. YACS with lower incomes and less education were more likely to smoke than the highest income and education reference groups. Females YACS and those with higher educational levels were more likely to have inadequate sleep. An analysis examining health risk behaviors of YACS compared to their never-cancer cohort demonstrated similar patterns of health risk behaviors between both groups at differing age/developmental time periods. Both samples were more likely to participate in heavy drinking and smoking in their middle versus later adult years and both samples were more likely to have inadequate sleep and be inactive in late adulthood.

 

Discussion

This study sheds light on the large number of young adult cancer survivors (approximately one-third) who participate in health risk behaviors. Even though the numbers are smaller than their never-cancer cohort, any activity in these behaviors may jeopardize survivors’ future health. Open dialogues with YACS from the moment of diagnosis and throughout treatment and recovery can help to reduce health risks and disparities among this vulnerable population and foster long healthy survivorship.