title: Cancer prevention and screening practices of siblings of childhood cancer survivors: a report from the Childhood Cancer Survivor Study.
abstract: BACKGROUND
  To compare the skin and breast/cervical cancer prevention/screening practices of adult siblings of childhood cancer survivors with controls and to identify modifying factors for these practices.
  
  
  METHODS
  Cross-sectional, self-report data from 2,588 adult siblings of 5+ year survivors of childhood cancer were analyzed to assess cancer prevention/screening practices. Two age, sex, and race/ethnicity-matched samples (N = 5,915 and N = 37,789) of the Behavioral Risk Factor Surveillance System participants served as the comparison populations. Sociodemographic and cancer-related data were explored as modifying factors for sibling cancer prevention/screening practices through multivariable logistic regression.
  
  
  RESULTS
  Compared with controls, siblings were more likely to practice skin cancer prevention behaviors: use of protective clothing [OR, 2.85; 95% confidence interval (CI), 2.39-3.39], use of shade (OR, 2.11; 95% CI, 1.88-2.36), use of sunscreen (OR, 1.27; 95% CI, 1.14-1.40), and wearing a hat (OR, 1.77; 95% CI, 1.58-1.98). No differences were noted for breast/cervical cancer screening including mammography and Pap testing. Having less than a high school education and lack of health insurance were associated with diminished cancer prevention/screening behaviors. Survivor diagnosis, treatment intensity, adverse health, chronic health conditions, and second cancers were not associated with sibling cancer prevention/screening behaviors.
  
  
  CONCLUSIONS
  Siblings of cancer survivors report greater skin cancer prevention practices when compared with controls; however, no differences were noted for breast/cervical cancer screening practices. Access to care and lack of education may be associated with decreased cancer prevention/screening behaviors. Interventions are needed to address these barriers.
  
  
  CONCLUSIONS
  Research should be directed at understanding the impact of the cancer experience on sibling health behaviors.
authors.affiliation: Department of Pediatrics and Division of Hematology at Children's Hospital of Orange County, Orange, CA 92868, USA. dbuchbinder@choc.org
authors.forename: David
authors.initials: D
authors.lastname: Buchbinder
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
authors.forename: Lonnie K
authors.initials: LK
authors.lastname: Zeltzer
authors.forename: Wendy
authors.initials: W
authors.lastname: Leisenring
authors.forename: Pam
authors.initials: P
authors.lastname: Goodman
authors.forename: E Anne
authors.initials: EA
authors.lastname: Lown
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Alderfer
authors.forename: Christopher
authors.initials: C
authors.lastname: Recklitis
authors.forename: Kevin
authors.initials: K
authors.lastname: Oeffinger
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Armstrong
authors.forename: Melissa
authors.initials: M
authors.lastname: Hudson
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Casillas
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D011379:Prognosis; D012189:Retrospective Studies; D057566:Self Report; D035781:Siblings; D015996:Survival Rate; D017741:Survivors; D055815:Young Adult