title: Surveillance of demographic characteristics and health behaviors among adult cancer survivors--Behavioral Risk Factor Surveillance System, United States, 2009.
abstract: OBJECTIVE
  Approximately 12 million people are living with cancer in the United States. Limited information is available on national and state assessments of health behaviors among cancer survivors. Using data from the Behavioral Risk Factor Surveillance System (BRFSS), this report provides a descriptive state-level assessment of demographic characteristics and health behaviors among cancer survivors aged ≥18 years.
  
  
  METHODS
  2009
  
  
  METHODS
  BRFSS is an ongoing, state-based, random-digit-dialed telephone survey of the noninstitutionalized U.S. population aged ≥18 years. BRFSS collects information on health risk behaviors and use of preventive health services related to leading causes of death and morbidity. In 2009, BRFSS added questions about previous cancer diagnoses to the core module. The 2009 BRFSS also included an optional cancer survivorship module that assessed cancer treatment history and health insurance coverage for cancer survivors. In 2009, all 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands administered the core cancer survivorship questions, and 10 states administered the optional supplemental cancer survivorship module. Five states added questions on mammography and Papanicolaou (Pap) test use, eight states included questions on colorectal screening, and five states included questions on prostate cancer screening.
  
  
  RESULTS
  An estimated 7.2% of the U.S. general population aged ≥18 years reported having received a previous cancer diagnosis (excluding nonmelanoma skin cancer). A total of 78.8% of cancer survivors were aged ≥50 years, and 39.2% had received a diagnosis of cancer >10 years previously. A total of 57.8% reported receiving an influenza vaccination during the previous year, and 48.3% reported ever receiving a pneumococcal vaccination. At the time of the interview, 6.8% of cancer survivors had no health insurance, and 12% had been denied health insurance, life insurance, or both because of their cancer diagnosis. The prevalence of cardiovascular disease was higher among male cancer survivors (23.4%) than female cancer survivors (14.3%), as was the prevalence of diabetes (19.6% and 14.7%, respectively). Overall, approximately 15.1% of cancer survivors were current cigarette smokers, 27.5% were obese, and 31.5% had not engaged in any leisure-time physical activity during the past 30 days. Demographic characteristics and health behaviors among cancer survivors varied substantially by state.
  
  
  CONCLUSIONS
  Health behaviors and preventive health care practices among cancer survivors vary by state and demographic characteristics. A large proportion of cancer survivors have comorbid conditions, currently smoke, do not participate in any leisure-time physical activity, and are obese. In addition, many are not receiving recommended preventive care, including cancer screening and influenza and pneumococcal vaccinations.
  
  
  CONCLUSIONS
  Health-care providers and patients should be aware of the importance of preventive care, smoking cessation, regular physical activity, and maintaining a healthy weight for cancer survivors. The findings in this report can help public health practitioners, researchers, and comprehensive cancer control programs evaluate the effectiveness of program activities for cancer survivors, assess the needs of cancer survivors at the state level, and allocate appropriate resources to address those needs.
authors.affiliation: CDC, Atlanta, GA 30341, USA. jmunderwood@cdc.gov
authors.forename: J Michael
authors.initials: JM
authors.lastname: Underwood
authors.forename: Julie S
authors.initials: JS
authors.lastname: Townsend
authors.forename: Sherri L
authors.initials: SL
authors.lastname: Stewart
authors.forename: Natasha
authors.initials: N
authors.lastname: Buchannan
authors.forename: Donatus U
authors.initials: DU
authors.lastname: Ekwueme
authors.forename: Nikki A
authors.initials: NA
authors.lastname: Hawkins
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Brandy
authors.initials: B
authors.lastname: Peaker
authors.forename: Lori A
authors.initials: LA
authors.lastname: Pollack
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Richards
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Rim
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Rohan
authors.forename: Susan A
authors.initials: SA
authors.lastname: Sabatino
authors.forename: Judith L
authors.initials: JL
authors.lastname: Smith
authors.forename: Eric
authors.initials: E
authors.lastname: Tai
authors.forename: George-Ann
authors.initials: GA
authors.lastname: Townsend
authors.forename: Arica
authors.initials: A
authors.lastname: White
authors.forename: Temeika L
authors.initials: TL
authors.lastname: Fairley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D015438:Health Behavior; D005102:Health Expenditures; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage; D019458:Insurance Coverage; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D009765:Obesity / Q000453:epidemiology; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D015995:Prevalence; D011634:Public Health; D011788:Quality of Life; D057185:Sedentary Behavior; D012737:Sex Factors; D012907:Smoking; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines