title: Provider counseling about health behaviors among cancer survivors in the United States.
abstract: OBJECTIVE
  To examine provider discussion or counseling of US cancer survivors about diet, exercise, and tobacco use.
  
  
  METHODS
  We used 2000 National Health Interview Survey data to examine whether US cancer survivors reported that, within 1 year, a provider (1) discussed diet, (2) recommended they begin or continue exercise, or (3) asked about smoking. We included survivors more than 1 year beyond diagnosis (n = 1,600) and adults without cancer (AWCs; n = 24,636) who saw/talked to a provider within 1 year. We used generalized linear contrasts in bivariable analyses and logistic regression to calculate predicted marginals adjusted for age, sex, comorbidity, usual source of care, and number of provider visits in the prior year.
  
  
  RESULTS
  Few survivors reported discussions or recommendations for all three health behaviors (10% of survivors v 9% of AWCs; P = .57). Although report was more likely than among AWCs, few survivors reported diet discussions (30% of survivors v 23% of AWCs; P < .0001) or exercise recommendations (26% of survivors v 23% of AWCs; P < .005), and a minority were asked about smoking (42% of survivors v 41% of AWCs; P = .41). After adjustment, survivors were less likely to report exercise recommendations than were AWCs (22% v 24%, respectively; P = .02). Colorectal cancer survivors were less likely than were AWCs of similar age range to report exercise recommendations (16% v 27%, respectively; P < .003) or smoking discussions (31% v 41%, respectively; P < .05). Cervical cancer survivors were more likely than AWCs of similar age range to discuss smoking (58% v 43%, respectively; P < .001).
  
  
  CONCLUSIONS
  Findings from this nationally representative sample suggest that many providers may miss opportunities to counsel survivors about healthy behaviors, perhaps particularly colorectal cancer survivors.
authors.affiliation: Division of Cancer Prevention and Control, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA30341, USA. ssabatino@cdc.gov
authors.forename: Susan A
authors.initials: SA
authors.lastname: Sabatino
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Coates
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Uhler
authors.forename: Lori A
authors.initials: LA
authors.lastname: Pollack
authors.forename: Linda G
authors.initials: LG
authors.lastname: Alley
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Zauderer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003376:Counseling; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D012907:Smoking; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D014481:United States / Q000453:epidemiology