Clustering of health behaviours in adult survivors of childhood cancer and the general population

C E Rebholz, C S Rueegg, G Michel, R A Ammann, N X von der Weid, C E Kuehni, B D Spycher, Swiss Paediatric Oncology Group (SPOG), R Angst, M Paulussen, T Kühne, A Hirt, K Leibundgut, A H Ozsahin, M Beck Popovic, Nobile Buetti, Pierluigi Brazzola, U Caflisch, J Greiner, H Hengartner, M Grotzer, F Niggli, C E Rebholz, C S Rueegg, G Michel, R A Ammann, N X von der Weid, C E Kuehni, B D Spycher, Swiss Paediatric Oncology Group (SPOG), R Angst, M Paulussen, T Kühne, A Hirt, K Leibundgut, A H Ozsahin, M Beck Popovic, Nobile Buetti, Pierluigi Brazzola, U Caflisch, J Greiner, H Hengartner, M Grotzer, F Niggli

Abstract

Background: Little is known about engagement in multiple health behaviours in childhood cancer survivors.

Methods: Using latent class analysis, we identified health behaviour patterns in 835 adult survivors of childhood cancer (age 20-35 years) and 1670 age- and sex-matched controls from the general population. Behaviour groups were determined from replies to questions on smoking, drinking, cannabis use, sporting activities, diet, sun protection and skin examination.

Results: The model identified four health behaviour patterns: 'risk-avoidance', with a generally healthy behaviour; 'moderate drinking', with higher levels of sporting activities, but moderate alcohol-consumption; 'risk-taking', engaging in several risk behaviours; and 'smoking', smoking but not drinking. Similar proportions of survivors and controls fell into the 'risk-avoiding' (42% vs 44%) and the 'risk-taking' cluster (14% vs 12%), but more survivors were in the 'moderate drinking' (39% vs 28%) and fewer in the 'smoking' cluster (5% vs 16%). Determinants of health behaviour clusters were gender, migration background, income and therapy.

Conclusion: A comparable proportion of childhood cancer survivors as in the general population engage in multiple health-compromising behaviours. Because of increased vulnerability of survivors, multiple risk behaviours should be addressed in targeted health interventions.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Illustration of behaviour groups identified by LCA as the number of classes was increased. The boxes in a given layer represent the behaviour groups identified in that model. Numbers of individuals and percentage of sample allocated to the group are reported next to the boxes.
Figure 2
Figure 2
Prevalence of health behaviours within the four health-behaviour patterns identified. The prevalence of the response categories of a given variable are connected with lines to better visualise differences between the behaviour patterns. , Cluster D1: risk-avaiding;, Cluster D2: moderate drinking;, Cluster D3: risk-taking;, Cluster D4: smoking. Abbreviations: v=vegetables; f=fruits.

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