title: Health behaviors, quality of life, and psychosocial health among survivors of adolescent and young adult cancers.
abstract: OBJECTIVE
  Survivors of adolescent and young adult (AYA) cancer may engage in unhealthy lifestyles (e.g., smoking), potentially heightening their risk for long-term health problems. We assessed health behaviors and constructs including quality of life (QOL) and psychosocial well-being among survivors of AYA cancer compared to the general population.
  
  
  METHODS
  We used 2009 Behavioral Risk Factor Surveillance System data to evaluate health behaviors for survivors of AYA cancer compared to AYAs without cancer. Multivariable regressions assessed health behaviors (smoking, binge drinking, physical inactivity, and low fruit/vegetable intake) by sex and age between AYA survivors and controls, and among survivors to determine the effects of demographic, QOL, psychosocial, and cancer factors on behaviors.
  
  
  RESULTS
  A greater proportion of female survivors of AYA cancer smoked than controls (currently aged 20-39: 27 vs. 14.3%, respectively; currently aged 40-64: 29.3 vs. 18.4%, respectively). Generally, survivors and controls were non-adherent to national health behavior guidelines. Uninsured survivors were at greater risk of smoking vs. insured (females, Relative Risk (RR) = 1.64, 95% confidence interval (CI) 1.43-1.90; males, RR = 2.62, 95% CI 1.71-4.02). Poor social/emotional support was associated with smoking (RR = 1.26, 95% CI 1.07-1.48) among female survivors and was associated with low fruit/vegetable intake among male (RR = 1.12, 95% CI 1.01-1.23) and female (RR= 1.12, 95% CI 1.05-1.19) survivors. Female survivors >10 years from diagnosis had higher risk of smoking (RR = 1.26-1.91, all p < 0.01) than survivors 5-10 years from diagnosis.
  
  
  CONCLUSIONS
  Unhealthy lifestyle behaviors are common in survivors of AYA cancer.
  
  
  CONCLUSIONS
  AYA survivors require health behavior support.
authors.affiliation: Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4125, Salt Lake City, UT, 84112, USA. echo.warner@hci.utah.edu.
authors.forename: Echo L
authors.identifier: http://orcid.org/0000-0002-5998-9744
authors.initials: EL
authors.lastname: Warner
authors.affiliation: Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4125, Salt Lake City, UT, 84112, USA.
authors.forename: Gina E
authors.initials: GE
authors.lastname: Nam
authors.affiliation: Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
authors.forename: Molly
authors.initials: M
authors.lastname: McFadden
authors.affiliation: Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wright
authors.affiliation: Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
authors.forename: Holly
authors.initials: H
authors.lastname: Spraker-Perlman
authors.affiliation: Department of Internal Medicine and University of New Mexico Cancer Center, University of New Mexico, 1 University Blvd NE, Albuquerque, NM, USA.
authors.forename: Anita Y
authors.initials: AY
authors.lastname: Kinney
authors.affiliation: Department of Medicine and Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Oeffinger
authors.affiliation: Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4125, Salt Lake City, UT, 84112, USA.|Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Kirchhoff
mesh_terms: D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D055815:Young Adult
keywords: Adolescent and young adult; Binge drinking; Diet; Exercise; Quality of life; Smoking