Patterns and predictors of clustered risky health behaviors among adult survivors of childhood cancer

A report from the Childhood Cancer Survivor Study

E. Anne Lown, Nobuko Hijiya, Nan Zhang, Deo Kumar Srivastava, Wendy M. Leisenring, Paul C. Nathan, Sharon M. Castellino, Katie A. Devine, Kimberley Dilley, Kevin R. Krull, Kevin C. Oeffinger, Melissa M. Hudson, Gregory Armstrong, Leslie L. Robison, Kirsten K. Ness

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND: Health complications related to childhood cancer may be influenced by risky health behaviors (RHBs), particularly when RHBs co-occur. To the authors' knowledge, only limited information is available describing how RHBs cluster among survivors of childhood cancer and their siblings and the risk factors for co-occurring RHBs. METHODS: Latent class analysis was used to identify RHB clusters using longitudinal survey data regarding smoking, alcohol use, and physical activity from adult survivors (4184 survivors) and siblings (1598 siblings) in the Childhood Cancer Survivor Study. Generalized logistic regression was used to evaluate associations between demographic characteristics, treatment exposures, psychological distress, health conditions, and cluster membership. RESULTS: Three RHB clusters were identified: a low-risk cluster, an insufficiently active cluster, and a high-risk cluster (tobacco and risky alcohol use and insufficient activity). Compared with siblings, survivors were more likely to be in the insufficiently active cluster (adjusted odds ratio [ORadj], 1.17; 95% confidence interval [95% CI], 1.06-1.27) and were less likely to be in the high-risk cluster (ORadj, 0.79; 95% CI, 0.69-0.88). Risk factors for membership in the high-risk cluster included psychological distress (ORadj, 2.76; 95% CI, 1.98-3.86), low educational attainment (ORadj, 7.49; 95% CI, 5.15-10.88), income <$20,000 (ORadj, 2.62; 95% CI, 1.93-3.57), being divorced/separated or widowed (ORadj, 1.36; 95% CI, 1.03-1.79), and limb amputation (ORadj, 1.52; 95% CI, 1.03-2.24). Risk factors for the insufficiently active cluster included chronic health conditions, psychological distress, low education or income, being obese or overweight, female sex, nonwhite race/ethnicity, single marital status, cranial radiation, and cisplatin exposure. CONCLUSIONS: RHBs co-occur in survivors of childhood cancer and their siblings. Economic and educational disadvantages and psychological distress should be considered in screening and interventions to reduce RHBs. Cancer 2016.

Original languageEnglish (US)
Pages (from-to)2747-2756
Number of pages10
JournalCancer
Volume122
Issue number17
DOIs
StatePublished - Sep 1 2016

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Health Behavior
Survivors
Confidence Intervals
Siblings
Neoplasms
Psychology
Health
Alcohols
Widowhood
Divorce
Marital Status
Amputation
Cisplatin
Tobacco
Longitudinal Studies
Extremities
Logistic Models
Smoking
Odds Ratio
Economics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Lown, E. A., Hijiya, N., Zhang, N., Srivastava, D. K., Leisenring, W. M., Nathan, P. C., ... Ness, K. K. (2016). Patterns and predictors of clustered risky health behaviors among adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. Cancer, 122(17), 2747-2756. https://doi.org/10.1002/cncr.30106

Patterns and predictors of clustered risky health behaviors among adult survivors of childhood cancer : A report from the Childhood Cancer Survivor Study. / Lown, E. Anne; Hijiya, Nobuko; Zhang, Nan; Srivastava, Deo Kumar; Leisenring, Wendy M.; Nathan, Paul C.; Castellino, Sharon M.; Devine, Katie A.; Dilley, Kimberley; Krull, Kevin R.; Oeffinger, Kevin C.; Hudson, Melissa M.; Armstrong, Gregory; Robison, Leslie L.; Ness, Kirsten K.

In: Cancer, Vol. 122, No. 17, 01.09.2016, p. 2747-2756.

Research output: Contribution to journalArticle

Lown, EA, Hijiya, N, Zhang, N, Srivastava, DK, Leisenring, WM, Nathan, PC, Castellino, SM, Devine, KA, Dilley, K, Krull, KR, Oeffinger, KC, Hudson, MM, Armstrong, G, Robison, LL & Ness, KK 2016, 'Patterns and predictors of clustered risky health behaviors among adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study', Cancer, vol. 122, no. 17, pp. 2747-2756. https://doi.org/10.1002/cncr.30106
Lown, E. Anne ; Hijiya, Nobuko ; Zhang, Nan ; Srivastava, Deo Kumar ; Leisenring, Wendy M. ; Nathan, Paul C. ; Castellino, Sharon M. ; Devine, Katie A. ; Dilley, Kimberley ; Krull, Kevin R. ; Oeffinger, Kevin C. ; Hudson, Melissa M. ; Armstrong, Gregory ; Robison, Leslie L. ; Ness, Kirsten K. / Patterns and predictors of clustered risky health behaviors among adult survivors of childhood cancer : A report from the Childhood Cancer Survivor Study. In: Cancer. 2016 ; Vol. 122, No. 17. pp. 2747-2756.
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title = "Patterns and predictors of clustered risky health behaviors among adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study",
abstract = "BACKGROUND: Health complications related to childhood cancer may be influenced by risky health behaviors (RHBs), particularly when RHBs co-occur. To the authors' knowledge, only limited information is available describing how RHBs cluster among survivors of childhood cancer and their siblings and the risk factors for co-occurring RHBs. METHODS: Latent class analysis was used to identify RHB clusters using longitudinal survey data regarding smoking, alcohol use, and physical activity from adult survivors (4184 survivors) and siblings (1598 siblings) in the Childhood Cancer Survivor Study. Generalized logistic regression was used to evaluate associations between demographic characteristics, treatment exposures, psychological distress, health conditions, and cluster membership. RESULTS: Three RHB clusters were identified: a low-risk cluster, an insufficiently active cluster, and a high-risk cluster (tobacco and risky alcohol use and insufficient activity). Compared with siblings, survivors were more likely to be in the insufficiently active cluster (adjusted odds ratio [ORadj], 1.17; 95{\%} confidence interval [95{\%} CI], 1.06-1.27) and were less likely to be in the high-risk cluster (ORadj, 0.79; 95{\%} CI, 0.69-0.88). Risk factors for membership in the high-risk cluster included psychological distress (ORadj, 2.76; 95{\%} CI, 1.98-3.86), low educational attainment (ORadj, 7.49; 95{\%} CI, 5.15-10.88), income <$20,000 (ORadj, 2.62; 95{\%} CI, 1.93-3.57), being divorced/separated or widowed (ORadj, 1.36; 95{\%} CI, 1.03-1.79), and limb amputation (ORadj, 1.52; 95{\%} CI, 1.03-2.24). Risk factors for the insufficiently active cluster included chronic health conditions, psychological distress, low education or income, being obese or overweight, female sex, nonwhite race/ethnicity, single marital status, cranial radiation, and cisplatin exposure. CONCLUSIONS: RHBs co-occur in survivors of childhood cancer and their siblings. Economic and educational disadvantages and psychological distress should be considered in screening and interventions to reduce RHBs. Cancer 2016.",
author = "Lown, {E. Anne} and Nobuko Hijiya and Nan Zhang and Srivastava, {Deo Kumar} and Leisenring, {Wendy M.} and Nathan, {Paul C.} and Castellino, {Sharon M.} and Devine, {Katie A.} and Kimberley Dilley and Krull, {Kevin R.} and Oeffinger, {Kevin C.} and Hudson, {Melissa M.} and Gregory Armstrong and Robison, {Leslie L.} and Ness, {Kirsten K.}",
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T2 - A report from the Childhood Cancer Survivor Study

AU - Lown, E. Anne

AU - Hijiya, Nobuko

AU - Zhang, Nan

AU - Srivastava, Deo Kumar

AU - Leisenring, Wendy M.

AU - Nathan, Paul C.

AU - Castellino, Sharon M.

AU - Devine, Katie A.

AU - Dilley, Kimberley

AU - Krull, Kevin R.

AU - Oeffinger, Kevin C.

AU - Hudson, Melissa M.

AU - Armstrong, Gregory

AU - Robison, Leslie L.

AU - Ness, Kirsten K.

PY - 2016/9/1

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N2 - BACKGROUND: Health complications related to childhood cancer may be influenced by risky health behaviors (RHBs), particularly when RHBs co-occur. To the authors' knowledge, only limited information is available describing how RHBs cluster among survivors of childhood cancer and their siblings and the risk factors for co-occurring RHBs. METHODS: Latent class analysis was used to identify RHB clusters using longitudinal survey data regarding smoking, alcohol use, and physical activity from adult survivors (4184 survivors) and siblings (1598 siblings) in the Childhood Cancer Survivor Study. Generalized logistic regression was used to evaluate associations between demographic characteristics, treatment exposures, psychological distress, health conditions, and cluster membership. RESULTS: Three RHB clusters were identified: a low-risk cluster, an insufficiently active cluster, and a high-risk cluster (tobacco and risky alcohol use and insufficient activity). Compared with siblings, survivors were more likely to be in the insufficiently active cluster (adjusted odds ratio [ORadj], 1.17; 95% confidence interval [95% CI], 1.06-1.27) and were less likely to be in the high-risk cluster (ORadj, 0.79; 95% CI, 0.69-0.88). Risk factors for membership in the high-risk cluster included psychological distress (ORadj, 2.76; 95% CI, 1.98-3.86), low educational attainment (ORadj, 7.49; 95% CI, 5.15-10.88), income <$20,000 (ORadj, 2.62; 95% CI, 1.93-3.57), being divorced/separated or widowed (ORadj, 1.36; 95% CI, 1.03-1.79), and limb amputation (ORadj, 1.52; 95% CI, 1.03-2.24). Risk factors for the insufficiently active cluster included chronic health conditions, psychological distress, low education or income, being obese or overweight, female sex, nonwhite race/ethnicity, single marital status, cranial radiation, and cisplatin exposure. CONCLUSIONS: RHBs co-occur in survivors of childhood cancer and their siblings. Economic and educational disadvantages and psychological distress should be considered in screening and interventions to reduce RHBs. Cancer 2016.

AB - BACKGROUND: Health complications related to childhood cancer may be influenced by risky health behaviors (RHBs), particularly when RHBs co-occur. To the authors' knowledge, only limited information is available describing how RHBs cluster among survivors of childhood cancer and their siblings and the risk factors for co-occurring RHBs. METHODS: Latent class analysis was used to identify RHB clusters using longitudinal survey data regarding smoking, alcohol use, and physical activity from adult survivors (4184 survivors) and siblings (1598 siblings) in the Childhood Cancer Survivor Study. Generalized logistic regression was used to evaluate associations between demographic characteristics, treatment exposures, psychological distress, health conditions, and cluster membership. RESULTS: Three RHB clusters were identified: a low-risk cluster, an insufficiently active cluster, and a high-risk cluster (tobacco and risky alcohol use and insufficient activity). Compared with siblings, survivors were more likely to be in the insufficiently active cluster (adjusted odds ratio [ORadj], 1.17; 95% confidence interval [95% CI], 1.06-1.27) and were less likely to be in the high-risk cluster (ORadj, 0.79; 95% CI, 0.69-0.88). Risk factors for membership in the high-risk cluster included psychological distress (ORadj, 2.76; 95% CI, 1.98-3.86), low educational attainment (ORadj, 7.49; 95% CI, 5.15-10.88), income <$20,000 (ORadj, 2.62; 95% CI, 1.93-3.57), being divorced/separated or widowed (ORadj, 1.36; 95% CI, 1.03-1.79), and limb amputation (ORadj, 1.52; 95% CI, 1.03-2.24). Risk factors for the insufficiently active cluster included chronic health conditions, psychological distress, low education or income, being obese or overweight, female sex, nonwhite race/ethnicity, single marital status, cranial radiation, and cisplatin exposure. CONCLUSIONS: RHBs co-occur in survivors of childhood cancer and their siblings. Economic and educational disadvantages and psychological distress should be considered in screening and interventions to reduce RHBs. Cancer 2016.

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