title: Lifestyle factors and health-related quality of life in colorectal cancer survivors.
abstract: OBJECTIVE
  This study investigates the association between a postdiagnosis lifestyle score and health-related quality of life (HrQol) in long-term colorectal cancer (CRC) survivors.
  
  
  METHODS
  A cross-sectional study of 1,389 long-term CRC survivors in Northern Germany was analyzed. On average 7.2 years after CRC diagnosis, HrQol was assessed with the EORTC QLQ-C30, and lifestyle factors, including weight, height, diet, physical activity, and smoking were obtained using self-administered questionnaires. A lifestyle score (BMI <30 kg/m², healthy diet, recreationally active, and not smoking) was applied. Participants were categorized in adhering to at most one, two, three, or all recommended lifestyle factors, categorizing unfavorable behaviors with 0 and favorable with 1 point. Multivariable logistic regression models were used to investigate the association between the lifestyle score and HrQol as a binary variable.
  
  
  RESULTS
  Approximately 10 % had at most one, 30 % two, 38 % three, and 23 % all favorable factors. Compared to participants with one or zero factors, the odds ratio (OR) for a low global HrQol (gHrQol) decreased with stronger adherence to the score. The OR (95% CI) for a low gHrQol was 0.50 (0.33-0.76) for participants with all favorable lifestyle factors compared to participants with one or zero. Clinical and socio-demographic factors had little impact on these associations, with exception of living arrangement which showed a statistically significant interaction. Associations were stronger for functioning domains, representing mobility rather than mental health.
  
  
  CONCLUSIONS
  Favorable lifestyle behaviors might be associated with HrQol in CRC long-term survivors. More research in prospective studies is needed.
authors.affiliation: Institute of Epidemiology, Christian-Albrechts University of Kiel, Campus Kiel, UKSH, Arnold-Heller-Str. 3, Haus 1, 24105, Kiel, Germany, sabrina.schlesinger@epi.uni-kiel.de.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Schlesinger
authors.forename: Jessica
authors.initials: J
authors.lastname: Walter
authors.forename: Jochen
authors.initials: J
authors.lastname: Hampe
authors.forename: Witigo
authors.initials: W
authors.lastname: von Schönfels
authors.forename: Sebastian
authors.initials: S
authors.lastname: Hinz
authors.forename: Thomas
authors.initials: T
authors.lastname: Küchler
authors.forename: Gunnar
authors.initials: G
authors.lastname: Jacobs
authors.forename: Clemens
authors.initials: C
authors.lastname: Schafmayer
authors.forename: Ute
authors.initials: U
authors.lastname: Nöthlings
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D005858:Germany; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors