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Longitudinal Changes in Lifestyle Behaviors and Health Status in Colon Cancer Survivors

¹ Department of Nutrition, ² Lineberger Comprehensive Cancer Center, ³ Center for Gastrointestinal Biology and Disease and Division of Digestive Diseases and Nutrition, ⁴ Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; ⁵ Amgen, Inc., Thousand Oaks, California; and ⁶ Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas

Requests for reprints: Jessie A. Satia, Amgen, Inc., Department of Epidemiology, One Amgen Center Drive, MS: 24-1-C, Thousand Oaks, CA 91320-1799. Phone: (805) 313-4097; Fax: (805) 447-1984. E-mail: jessie.satia{at}amgen.com

Lifestyle changes in persons diagnosed with cancer are important because they may impact prognosis, co-morbidities, and survival. This report describes longitudinal changes in lifestyle behaviors and health status among colon cancer survivors (n = 278) and population-based controls (n = 459) in North Carolina (39% African American), and examines demographic and psychosocial correlates of healthy lifestyle changes following a colon cancer diagnosis. Data are from surveys of a population-based cohort of colon cancer patients on diagnosis (the North Carolina Colon Cancer Study, NCCCS) and approximately 2 years post-diagnosis [the North Carolina Strategies to Improve Diet, Exercise, and Screening Study (NC STRIDES)], and population-based controls. Both studies collected information on demographic/lifestyle characteristics and medical history. The NCCCS reflects pre-diagnosis or pre-interview patterns, whereas NC STRIDES queried on current practices. Between the NCCCS and NC STRIDES, colon cancer survivors reported significant increases in vegetable intake, physical activity, and supplement use (all P <0.01) and a non-statistically significant increase in fruit/juice consumption (0.1 serving), with larger fruit/vegetable changes in African Americans than Whites. Controls increased physical activity and supplement use and fewer reported arthritic symptoms (P < 0.05). Survivors who were older and female had an almost 3 times higher likelihood of having used at least one new dietary supplement post-diagnosis, whereas being retired correlated with increased vegetable intake, all P < 0.05. Having more barriers to increasing fruit/vegetable intake was inversely associated with taking a new supplement (P < 0.05 only in controls). Colon cancer survivors reported making significant improvements in multiple health-related behaviors. Health care providers should communicate with persons diagnosed with colon cancer to ensure that they are making healthy lifestyle changes.

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