Health-related behaviours in the EpiPorto study: cancer survivors versus participants with no cancer history

Cancer survivors are at an increased risk of a second primary cancer, partly due to unhealthy behaviours. In a cohort of adults (recruitment: 1999-2003; follow-up - linkage with population-based cancer registry: up to 2009) we compared the baseline exposure to smoking, alcohol and dietary intake and physical activity between: cancer survivors (CS) - cancer diagnosis before baseline (n=53); no cancer (NC) participants - without cancer diagnosis at baseline or during follow-up (n=2261); latent cancer (LC) participants - without cancer diagnosis at baseline but diagnosed during follow-up (n=139). Age-, sex- and education-adjusted prevalences and means were computed, as applicable. The prevalence of current smoking was nearly 20% among CS and NC (approximately four cigarettes per day) and 30% in LC (seven cigarettes per day). LC had the highest average alcohol intake (25.5 g/day) and NC the lowest (17.0 g/day). The proportion of participants reporting sports practice was higher for CS (50%) than for NC or LC (approximately 33%). CS and NC had higher fruit/vegetable consumption than LC (4.2 and 4.4 vs. 3.8 servings per day). In a composite index on health behaviours (including smoking, physical activity and alcohol and fruit/vegetable intake) the highest and lowest scores were 1.74 for NC and 1.52 for LC respectively, whereas CS scored 1.63. The exposure to each risk factor appeared comparable in CS and NC, whereas LC tended to have unhealthier behaviours. This may be partially explained by the acquisition of healthier habits by CS after diagnosis, but there still remains scope for improvement, as revealed by the low scores observed for the joint exposure to the main risk factors