title: Lifestyle Behaviors in Elderly Cancer Survivors: A Comparison With Middle-Age Cancer Survivors.
abstract: OBJECTIVE
  Improved cancer screening and treatment have led to a greater focus on cancer survivorship care. Older cancer survivors may be a unique population. We evaluated whether older cancer survivors (age ≥ 65 years) had lifestyle behaviors, attitudes, and knowledge distinct from younger survivors.
  
  
  METHODS
  Adult cancer survivors with diverse cancer subtypes were recruited from Princess Margaret Cancer Centre (Toronto, Ontario, Canada). Multivariable models evaluated the effect of age on smoking, alcohol, and physical activity habits, attitudes toward and knowledge of these habits on cancer outcomes, and lifestyle information and recommendations received from health care providers, adjusted for sociodemographic and clinicopathologic covariates.
  
  
  RESULTS
  Among the 616 survivors recruited, 23% (n = 139) were older. Median follow-up since diagnosis was 24 months. Older survivors were more likely ex-smokers and less likely current smokers than younger survivors, but they were less likely to know that smoking could affect cancer treatment (adjusted odds ratio [OR], 0.53; P = .007) or prognosis (adjusted OR, 0.53; P = .008). Older survivors were more likely to perceive alcohol as improving overall survival (adjusted OR, 2.39; P = .02). Rates of meeting moderate-to-vigorous physical activity guidelines 1 year before diagnosis (adjusted OR, 0.55; P = .02) and maintaining and improving their exercise levels to meet these guidelines after diagnosis (adjusted OR, 0.48; P = .02) were lower in older survivors. Older and younger cancer survivors reported similar rates of receiving lifestyle behavior information from health care providers (P = .36 to .98).
  
  
  CONCLUSIONS
  Older cancer survivors reported being less aware of the impact of smoking on their overall health, more likely perceived alcohol as beneficial to survival, and were less likely to meet exercise goals compared with younger survivors. Survivorship programs need to consider age when counseling on lifestyle behaviors.
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Chongya
authors.initials: C
authors.lastname: Niu
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Lawson
authors.initials: L
authors.lastname: Eng
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Xin
authors.initials: X
authors.lastname: Qiu
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Shen
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Espin-Garcia
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Yuyao
authors.initials: Y
authors.lastname: Song
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Dan
authors.initials: D
authors.lastname: Pringle
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Mary
authors.initials: M
authors.lastname: Mahler
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Oleksandr
authors.initials: O
authors.lastname: Halytskyy
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Charow
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Lam
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Ravi M
authors.initials: RM
authors.lastname: Shani
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Jodie
authors.initials: J
authors.lastname: Villeneuve
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Tiessen
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: M Catherine
authors.initials: MC
authors.lastname: Brown
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Selby
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Doris
authors.initials: D
authors.lastname: Howell
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Jones
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada geoffrey.liu@uhn.ca.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Liu
authors.affiliation: Princess Margaret Cancer Centre/University Health Network; University of Toronto; Ontario Cancer Institute; Toronto General Hospital/University Health Network; and Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Shabbir M H
authors.initials: SM
authors.lastname: Alibhai
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009369:Neoplasms / Q000628:therapy*; D010353:Patient Education as Topic; D012907:Smoking; D017741:Survivors / Q000523:psychology*; D055815:Young Adult