title: Health behaviors predict higher interleukin-6 levels among patients newly diagnosed with head and neck squamous cell carcinoma.
abstract: BACKGROUND
  Health behaviors have been shown to be associated with recurrence risk and survival rates in patients with cancer and are also associated with interleukin-6 (IL-6) levels, but few epidemiologic studies have investigated the relationship of health behaviors and IL-6 among cancer populations. The purpose of the study is to look at the relationship between five health behaviors, viz.: smoking, alcohol problems, body mass index (BMI; a marker of nutritional status), physical activity, and sleep and pretreatment IL-6 levels in persons with head and neck cancer.
  
  
  METHODS
  Patients (N = 409) were recruited in otolaryngology clinic waiting rooms and invited to complete written surveys. A medical record audit was also conducted. Descriptive statistics and multivariate analyses were conducted to determine which health behaviors were associated with higher IL-6 levels controlling for demographic and clinical variables among patients with newly diagnosed head and neck cancer.
  
  
  RESULTS
  While smoking, alcohol problems, BMI, physical activity, and sleep were associated with IL-6 levels in bivariate analysis, only smoking (current and former) and decreased sleep were independent predictors of higher IL-6 levels in multivariate regression analysis. Covariates associated with higher IL-6 levels were age and higher tumor stage, whereas comorbidities were marginally significant.
  
  
  CONCLUSIONS
  Health behaviors, particularly smoking and sleep disturbances, are associated with higher IL-6 levels among patients with head and neck cancer.
  
  
  CONCLUSIONS
  Treating health behavior problems, especially smoking and sleep disturbances, may be beneficial to decreasing IL-6 levels, which could have a beneficial effect on overall cancer treatment outcomes.
authors.affiliation: Corresponding Author: Sonia A. Duffy, University of Michigan, School of Nursing, 400 North Ingalls Building, Room 3178, Ann Arbor, MI 48109-5482, USA. bump@umich.edu
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Duffy
authors.forename: Theodoros
authors.initials: T
authors.lastname: Teknos
authors.forename: Jeremy M G
authors.initials: JM
authors.lastname: Taylor
authors.forename: Karen E
authors.initials: KE
authors.lastname: Fowler
authors.forename: Mozaffarul
authors.initials: M
authors.lastname: Islam
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Wolf
authors.forename: Scott
authors.initials: S
authors.lastname: McLean
authors.forename: Tamer A
authors.initials: TA
authors.lastname: Ghanem
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Terrell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000175:diagnosis / Q000523:psychology; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000523:psychology; D015438:Health Behavior; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008485:Medical Audit; D008499:Medical Records; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000150:complications; D012907:Smoking / Q000009:adverse effects
chemical_list: D015850:Interleukin-6