Do Long Term Cancer Survivors Have Better Health-Promoting Behavior than Non-Cancer Populations?: Case-Control Study in Korea

  • Chun, Sung-Youn (Department of Public Health, Graduate School, Yonsei University College of Medicine) ;
  • Park, Hyeki (Department of Public Health, Graduate School, Yonsei University College of Medicine) ;
  • Lee, Tae Hoon (Department of Public Health, Graduate School, Yonsei University College of Medicine) ;
  • Park, Eun-Cheol (Institute of Health Services Research, Yonsei University College of Medicine)
  • Published : 2015.03.09


Background: We compared the health-promoting behavior of long-term cancer survivors with those of the general population to identify necessary behavioral interventions to reduce the health risk among cancer patients. Materials and Methods: We used data from the 2007 and 2012 Korea National Health and Nutrition Examination Surveys (KNHANES IV [2007~2009] and KNHANES V [2010~2012]) on smoking status, alcohol use, physical exercise, and disease screening. We compared long-term cancer survivors with members of the general population; the controls were matched by propensity score matching. A multiple logistic regression model was used to investigate the association between cancer status and health-promoting behavior. Results: Long-term cancer survivors had a lower risk of smoking than the general population controls (OR: 0.42, 95%CI: 0.25-0.71). In addition, the long-term cancer survivors had a lower risk of alcohol use than the general population controls (OR: 0.70, 95%CI: 0.50-0.98). However, in terms of physical exercise and disease screening, no statistically significant differences were detected (physical exercise OR: 1.01, 95%CI: 0.75-1.35; disease screening OR: 1.27, 95%CI: 0.93-1.74). All covariates were adjusted. Conclusions: The long-term cancer survivors had a much lower risk of smoking and alcohol use than the general population controls. However, almost no differences in physical exercise and screening for cancer recurrence or secondary disease were detected between the long-term cancer survivors and general population controls. To reduce the health risks and challenges facing long-term cancer survivors, interventions to encourage physical exercise and screening for cancer recurrence and secondary disease should be implemented.


Supported by : Cancer Control, Ministry of Health and Welfare


  1. Alfano CM, Day JM, Katz ML, et al (2009). Exercise and dietary change after diagnosis and cancer-related symptoms in long-term survivors of breast cancer: CALGB 79804. Psychooncology, 18, 128-33.
  2. Bidstrup PE, Dalton SO, Christensen J, et al (2013). Changes in body mass index and alcohol and tobacco consumption among breast cancer survivors and cancer-free women: a prospective study in the danish diet, cancer and health cohort. Acta Oncol, 52, 327-35.
  3. Blanchard CM, Courneya KS, Stein K, et al (2008). Cancer survivors' adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society's SCS-II. J Clin Oncol, 26, 2198-204.
  4. Carmack CL, Basen-Engquist K, Gritz ER (2011). Survivors at higher risk for adverse late outcomes due to psychosocial and behavioral risk factors. Cancer Epidemiol Biomarkers Prev, 20, 2068-77.
  5. Cohen HJ, Lan L, Archer L, et al (2012). Impact of age, comorbidity and symptoms on physical function in longterm breast cancer survivors (CALGB 70803). J Geriatr Oncol, 3, 82-9.
  6. Hawkins NA, Smith T, Zhao L, et al (2010). Health-related behavior change after cancer: results of the American cancer society's studies of cancer survivors (SCS). J Cancer Surviv, 4, 20-32.
  7. Hudson SV, Hahn KA, Ohman-Strickland P, et al (2009). Breast, colorectal and prostate cancer screening for cancer survivors and non-cancer patients in community practices. J Gen Intern Med, 24, 487-90.
  8. Ihira H, Mizumoto A, Makino K, et al (2014). Physical functions, health-related outcomes, nutritional status, and blood markers in community-dwelling cancer survivors aged 75 years and older. Asian Pac J Cancer Prev, 15, 3305-10.
  9. Khan NF, Carpenter L, Watson E, et al (2010). Cancer screening and preventative care among long-term cancer survivors in the United Kingdom. Br J Cancer, 102, 1085-90.
  10. Lee JE, Loh SY (2013). Physical activity and quality of life of cancer survivors: a lack of focus for lifestyle redesign. Asian Pac J Cancer Prev, 14, 2551-5.
  11. Low CA, Beckjord E, Bovbjerg DH, et al (2014). Correlates of positive health behaviors in cancer survivors: Results from the 2010 LIVESTRONG Survey. J Psychosoc Oncol, 32, 678-95.
  12. Mayer DK, Terrin NC, Menon U, et al (2007). Screening practices in cancer survivors. J Cancer Surviv, 1, 17-26.
  13. Morrow JR, Jr., Jackson AW, Bazzarre TL, et al (1999). A oneyear follow-up to physical activity and health. A report of the Surgeon General. Am J Prev Med, 17, 24-30.
  14. Park SM, Park CT, Park SY, et al (2009). Factors related to second cancer screening practice in disease-free cervical cancer survivors. Cancer Causes Control, 20, 1697-703.
  15. Schmitz KH, Holtzman J, Courneya KS, et al (2005). Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev, 14, 1588-95.
  16. Schumacher JR, Witt WP, Palta M, et al (2012). Cancer screening of long-term cancer survivors. J Am Board Fam Med, 25, 460-9.
  17. Trask PC, Rabin C, Rogers ML, et al (2005). Cancer screening practices among cancer survivors. Am J Prev Med, 28, 351-6.
  18. Wang HH, Chung UL (2012). Healthy lifestyle changes during the period before and after cancer diagnosis among breast cancer survivors. Asian Pac J Cancer Prev, 13, 4769-72.
  19. Wayne S, Neuhouser ML, Ulrich CM, et al (2008). Association between alcohol intake and serum sex hormones and peptides differs by tamoxifen use in breast cancer survivors. Cancer Epidemiol Biomarkers Prev, 17, 3224-32.

Cited by

  1. Modifications in dietary and alcohol intakes between before and after cancer diagnosis: Results from the prospective population-based NutriNet-Santé cohort vol.141, pp.3, 2017,
  2. The Effects of a Culturally Tailored, Patient-Centered Psychosocial Intervention in South Korean Cancer Survivors pp.1552-3799, 2018,
  3. Psychosocial Adjustment in Korean Colorectal Cancer Survivors vol.48, pp.5, 2018,