title: Health management in cancer survivors: Findings from a population-based prospective cohort study-the Yamagata Study (Takahata).
abstract: The number of cancer survivors is increasing; however, optimal health management of cancer survivors remains unclear due to limited knowledge. To elucidate the risk of non-communicable diseases, and the effect of lifestyle habits on risk of non-communicable diseases, we compared cancer survivors and those who never had cancer (non-cancer controls) using a population-based prospective cohort study. The baseline survey of 2292 participants was carried out from 2004 to 2006, and the follow-up survey of 2124 participants was carried out in 2011. We compared the baseline characteristics and the risk of non-communicable diseases between cancer survivors and non-cancer controls. Analyzed participants included 124 cancer survivors (men/women, 57/67), and 2168 non-cancer controls (939/1229). Several lifestyle factors and nutritional intake significantly differed between survivors and non-cancer controls, although smoking status did not differ between the groups (P = 0.30). Univariate logistic regression analysis showed increased risk of death (odds ratio [OR], 3.64; 95% confidence interval [CI], 2.19-6.05) and heart disease (OR, 2.60; 95% CI, 1.06-6.39) in cancer survivors. Increased risk of heart disease was also significant (OR, 2.95; 95% CI, 1.05-8.26; P = 0.04) in the multivariate analysis of the smoking-related cancer subgroup. Current smoking significantly increased risk of death (OR, 2.42; 95% CI, 1.13-5.18). Specific management should be implemented for cancer survivors. More intense management against smoking is necessary, as continued smoking in cancer survivors may increase the risk of second primary cancer. Moreover, cancer survivors are at a high risk of heart disease; thus, additional care should be taken.
authors.affiliation: Department of Clinical Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
authors.forename: Sho
authors.identifier: http://orcid.org/0000-0002-5378-9477
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Public Health, Yamagata University Graduate School of Medicine, Yamagata, Japan.|Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Narimatsu
authors.affiliation: Department of Clinical Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan.|Department of Medical Oncology, Yamagata Prefectural Central Hospital, Yamagata, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Ito Sasahara
authors.affiliation: Department of Public Health, Yamagata University Graduate School of Medicine, Yamagata, Japan.
authors.forename: Ri
authors.initials: R
authors.lastname: Sho
authors.affiliation: Department of Public Health, Yamagata University Graduate School of Medicine, Yamagata, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Kawasaki
authors.affiliation: Department of Ophthalmology and Visual Sciences, Faculty of Medicine, Yamagata University, Yamagata, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Department of First Department of Internal Medicine, Faculty of Medicine, Yamagata University, Yamagata, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
authors.affiliation: Department of Second Department of Internal Medicine, Faculty of Medicine, Yamagata University, Yamagata, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ueno
authors.affiliation: Department of Third Department of Internal Medicine, Faculty of Medicine, Yamagata University, Yamagata, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Clinical Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshioka
authors.affiliation: Department of Public Health, Yamagata University Graduate School of Medicine, Yamagata, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Fukao
authors.affiliation: Department of Advanced Cancer Science, Faculty of Medicine, Yamagata University, Yamagata, Japan.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Kayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004032:Diet; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D017741:Survivors
keywords: Health behavior; lifestyle risk reduction; preventive health services; second cancer; survivors