title: Trends in modifiable lifestyle-related risk factors following diagnosis in breast cancer survivors.
abstract: OBJECTIVE
  Evidence suggests that high-risk lifestyle behaviors exacerbate the health of cancer survivors and increase cancer mortality. This study examined the prevalence of lifestyle-related risk factors among female breast cancer survivors by duration of survivorship in the United States.
  
  
  METHODS
  We analyzed data from 7,443 women aged ≥18 years who participated in the 2009 Behavioral Risk Factor Surveillance System and reported having ever-diagnosed breast cancer. Adjusted prevalence with 95 % confidence interval for lifestyle-related risk factors (including current smoking, excessive alcohol drinking, obesity, engaging in physical activity ≥150 min/week, and consuming fruits and vegetables ≥5 times/day) was estimated using log-linear regression while controlling for confounders.
  
  
  RESULTS
  Overall, the prevalence estimates for lifestyle-related risk factors were 10.2 % for current smoking, 6.8 % for excessive alcohol drinking, 24.7 % for obesity, 53.8 % for engaging in physical activity ≥150 min/week, and 33.9 % for consuming fruits and vegetables ≥5 times/day among female breast cancer survivors. After adjustment for covariates, with increasing years of survivorship, a linearly increasing trend was observed for current smoking (P = 0.038), and quadratic trends were observed for excessive alcohol drinking (P < 0.001) and obesity (P = 0.048). The adjusted prevalence estimates for engaging in physical activity ≥150 min/week and consuming fruits and vegetables ≥5 times/day did not vary significantly by duration of survivorship.
  
  
  CONCLUSIONS
  Continuing efforts on counseling and encouraging breast cancer survivors to adopt healthy lifestyles are needed to improve their health.
  
  
  CONCLUSIONS
  Understanding the trends of modifiable lifestyle-related risk factors among breast cancer survivors with varying duration of survivorship may assist health care providers to provide appropriate counseling for breast cancer patients to improve their health. Clinical and public health intervention programs should seek to maximize the number of recommended healthy behaviors especially in those women who are at high risk for failing to comply with the healthy lifestyle guidelines.
authors.affiliation: Division of Behavioral Surveillance, Public Health Surveillance Program Office, Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 2500 Century Parkway, Mailstop E-97, Atlanta, GA, 30345, USA, fwj4@cdc.gov.
authors.forename: Guixiang
authors.initials: G
authors.lastname: Zhao
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Li
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Okoro
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Xiao Jun
authors.initials: XJ
authors.lastname: Wen
authors.forename: Arica
authors.initials: A
authors.lastname: White
authors.forename: Lina S
authors.initials: LS
authors.lastname: Balluz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D040343:Behavioral Risk Factor Surveillance System; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult