Introduction
Methods
Design
Participants and recruitment
Measures
Statistical analyses
Health behaviour | Guidance |
---|---|
Physical activity | Check with healthcare team before starting an exercise plan or taking part in a new sport or recreational activities For adults—engage in moderate physical activity >30 min/day for >5 days per week For children and adolescents—engage in >60 min of moderate to vigorous physical activity for >5 days per week |
Diet | Choose a variety of foods from all the food groups (grains, vegetables, fruits, oil, milk, meat and beans) Use the steps to a healthier you guide to develop a well-balanced diet and activity plan (www.mypyramid.gov) |
Fruit/veg | Eat >5 servings of fruit and veg per day, including citrus fruits and dark green and deep yellow vegetables When drinking juice, choose 100% fruit or vegetable juice and limit to 4 oz. per day |
Milk/dairy | Choose low-fat milk and dairy products |
Meat | Limit intake of red meat and substitute with fish, poultry and beans When eating meat, select leaner or smaller portions |
Fibre | Eat plenty of high-fibre foods, such as whole grain breads, rice, pasta and cereals |
Fat | Decrease the amount fat in meals by baking, broiling or boiling foods Limit fried or high-fat foods |
Sugar | Limit refined carbohydrates, including pastries, sweetened cereal, soft drinks and sugar |
Salt intake | Avoid salt cured, smoked, charbroiled and pickled foods |
Alcohol | Limit alcoholic drinks to <2 drinks per day for men and <1 drink per day for women |
Smoking | Do not smoke |
Sun safety | Limit the amount of time in the sun especially between 10 am and 2 pm Regularly using sunscreen with a sun protection factor of 15 or more Cover up in the sun and do not actively try and tan |
Results
Participant characteristics
TYA cancer patients* n =83% (n) | TYA cancer survivors* n =174% (n) | General population TYAs n =321% (n) | |
---|---|---|---|
Age (mean ± SD) | 19±3.06 | 20.0±2.78 | 17±3.1 |
Gender | |||
Females | 55.4 (46) | 62.9 (109) | 77.6 (249) |
Males | 44.6 (37) | 37.4 (65) | 22.4 (72) |
Educational status** | |||
GSCE/standard grade/school cert | 65.1 (54) | 68.4 (119) | 48.9 (157) |
Vocational qualifications (e.g. NVQ1 + 2) | 18.1 (20) | 11.5 (20) | 2.5 (8) |
A-level/higher school cert | 38.6 (32) | 52.9 (92) | 14.3 (46) |
Bachelor degree | 8.4 (7) | 18.4 (32) | 9.3 (30) |
Masters/PhD/PGCE | 0 (0) | 5.2 (9) | 5.3 (17) |
Still studying | 41.0 (34) | 33.9 (59) | 62.3 (200) |
No formal qualifications | 4.8 (4) | 1.1 (2) | 2.2 (7) |
Other | 8.4 (7) | 5.7 (10) | 3.1 (10) |
Employment status** | |||
Employed full-time | 6.0 (5) | 21.8 (38) | 5.9 (19) |
Employed part-time | 14.5 (12) | 22.4 (39) | 7.2 (23) |
Self-employed | 0 (0) | 1.7 (3) | 1.6 (5) |
Unemployed | 4.8 (4) | 5.7 (10) | 8.1 (26) |
Full-time education | 39.8 (33) | 43.7 (76) | 77.3 (248) |
Part-time education | 6.0 (5) | 4.6 (8) | 0.9 (3) |
Unable or too ill to work/study | 37.3 (31) | 13.2 (23) | 0.3 (1) |
Voluntary work | 9.6 (8) | 6.9 (12) | 6.2 (20) |
Living arrangement | |||
Alone | 2.4 (2) | 6.9 (12) | 5 (16) |
With my partner | 10.8 (9) | 9.2 (16) | 4 (13) |
With immediate family | 77.1 (64) | 71.8 (125) | 80.1 (257) |
Other family | 3.6 (3) | 0.6 (1) | 1.9 (6) |
With friends | 4.8 (4) | 11.5 (20) | 7.8 (25) |
Residential care | 1.2 (1) | 0 (0) | 0.9 (3) |
Ethnicity | |||
White British | 75.9 (63) | 77.0 (134) | 41.1 (132) |
White Irish | 1.2 (1) | 1.1 (2) | 1.2 (4) |
Black African | 4.8 (4) | 2.9 (5) | 6.5 (21) |
Black Caribbean | 1.2 (1) | 1.1 (2) | 1.2 (4) |
Indian | 2.4 (2) | 1.7 (3) | 8.1 (26) |
Bangladeshi | 1.2 (1) | 2.9 (5) | 4.4 (14) |
Pakistani | 1.2 (1) | 2.9 (5) | 3.1 (10) |
Chinese | 0 (0) | 0 (0) | 4.4 (14) |
Mixed White and Black African | 0 (0) | 0.6 (1) | 1.6 (5) |
Mixed White and Black Caribbean | 2.4 (2) | 0.6 (1) | 1.2 (4) |
Mixed White and Asian | 1.2 (1) | 0.6 (1) | 3.7 (12) |
Other | 6.0 (5) | 8.0 (14) | 21.8 (70) |
Health characteristics
TYA cancer patients n =83% (n) | TYA cancer survivors n =174% (n) | TYA cancer survivors total n =267% (n) | |
Cancer diagnosis | |||
Lymphoma | 22.9 (19) | 31.5 (62) | 31.5 (81) |
Leukaemia | 34.9 (29) | 24.1 (42) | 27.6 (71) |
Bone tumour | 7.2 (6) | 10.9 (19) | 9.7 (25) |
Soft tissue sarcoma | 15.7 (13) | 5.7 (10) | 8.9 (23) |
CNS tumour | 10.8 (9) | 6.9 (12) | 8.2 (21) |
Germ cell tumour | 0 (0) | 5.2 (9) | 3.5 (9) |
Carcinoma | 3.6 (3) | 4.6 (8) | 4.3 (11) |
Melanoma | 2.4 (2) | 1.1 (2) | 1.6 (4) |
Other | 4.8 (4) | 8.0 (14.0) | 7 (18) |
Age at diagnosis (mean ± SD) | 17.0±4.1 | 16.2±4.5 | 16.4±4.4 |
0–12 years | 10.7 (8) | 15.1 (25) | 12.6 (33) |
13–18 years | 45.3 (34) | 54.8 (91) | 48.9 (127) |
19–24 years | 44.0 (33) | 30.1 (50) | 32.2 (84) |
Missing data | 9.6 (8) | 4.6 (8) | 6.2 (16) |
Treatment* | |||
Surgery | 56.9 (33) | 57.4 (70) | 57.2 (103) |
Radiotherapy | 51.8 (29) | 46.9 (58) | 50.3 (87) |
Chemotherapy | 94.6 (70) | 97.5 (156) | 96.6 (226) |
Hormone therapy | 5 (2) | 8.7 (8) | 7.6 (10) |
Active surveillance | 5 (2) | 8.9 (8) | 7.7 (10) |
None | 2.6 (1) | 1.1 (1) | 1.6 (2) |
Not sure | 5 (2) | 1.1 (1) | 2.4 (3) |
Other | 12 (10) | 13.7 (24) | 13.6 (36) |
Time since treatment** | |||
<3 months from finishing treatment | – | 13.2 (23) | – |
4–11 months since finishing treatment | – | 19 (33) | – |
1–5 years since finishing treatment | – | 46 (80) | – |
>5 years since finishing treatment | – | 5.7 (10) | – |
On active surveillance | – | 12.1 (21) | – |
I don’t know | – | 0.6 (1) | – |
Missing data | – | 3.4 (6) | – |
General population controls n =321% (n) | |||
Health problems | % (n) | % (n) | % (n) |
Osteoporosis | 0 (0) | 4 (7) | 0.3 (1) |
Diabetes | 4.8 (4) | 1.7 (3) | 0.6 (2) |
Asthma | 10.8 (9) | 8.6 (15) | 13.4 (43) |
Irregular heart rhythm | 7.2 (6) | 5.7 (10) | 1.9 (6) |
Extreme fatigue | 31.3 (26) | 29.9 (52) | 6.2 (20) |
Mental health problems | 16.9 (14) | 20.1 (35) | 14.3 (46) |
Lung disease | 0 (0) | 1.1 (2) | 0.3 (1) |
Arthritis | 1.2 (1) | 2.3 (4) | 0.6 (2) |
Any other heart trouble | 1.2 (1) | 1.7 (3) | 0.9 (3) |
Another cancer | 2.4 (2) | 1.1 (2) | 0.3 (1) |
Sensory impairment | 1.2 (1) | 5.2 (9) | 1.2 (4) |
Other | 34.1 (28) | 35.1 (61) | 7.8 (25) |
Weight classification | |||
Obese (BMI>30) | 13.3 (11) | 12.1 (21) | 2.5 (8) |
Overweight (BMI 25–29.9) | 18.1 (15) | 18.4 (32) | 6.5 (21) |
Healthy weight (BMI 18.5–24.9) | 50.6 (42) | 56.3 (98) | 51.4 (165) |
Underweight (BMI <18.5) | 7.2 (6) | 4.6 (8) | 19 (61) |
Missing data | 10.8 (9) | 8.6 (15) | 20.6 (66) |
Health behaviour status
Proportion meeting guidelines % (n) | Unadjusted | Adjusteda | |||
---|---|---|---|---|---|
Odds ratio (95% CI) | Odds ratio (95% CI) | Odds ratio (95% CI) | Odds ratio (95% CI) | ||
Physical activity (n =577) | |||||
GP-TYAs | 54.8 (176) | 1 | 1 | ||
TYA-CS | 52.3 (91) | 0.35 (0.21, 0.59) | 1 | 0.21 (0.81, 0.54) | 1 |
TYA-CP | 30.1 (25) | 0.89 (0.62, 1.29)* | 0.39 (0.22, 0.68)* | 0.54 (0.21, 1.36)* | 0.38 (0.21, 0.68)** |
Fat intake (n =440) | |||||
GP-TYAs | 24.5 (78) | 1 | 1 | ||
TYA-CS | 25.3 (44) | 1.48 (0.83, 2.64) | 1 | 3.41 (1.08, 10.77)* | 1 |
TYA-CP | 25.3 (21) | 1.41 (0.90, 2.21) | 0.80 (0.45–1.41) | 3.33 (1.05, 10.55)* | 0.781 (0.44, 1.38) |
Fibre intake (n =521) | |||||
GP-TYAs | 39.3 (126) | 1 | 1 | ||
TYA-CS | 26.4 (46) | 1.77 (1.17, 2.69)* | 1 | 1.62 (0.99, 2.67)* | 1 |
TYA-CP | 28.9 (24) | 1.68 (0.98, 2.88)* | 0.87 (0.47–1.59) | 1.55 (0.86, 2.81) | 0.949 (0.52, 1.71) |
Sugar intake (n =460) | |||||
GP-TYAs | 38.9 (125) | 1 | 1 | ||
TYA-CS | 32.2 (56) | 1.91 (1.25, 2.90)* | 1 | 1.84 (1.14, 2.95)** | 1 |
TYA-CP | 25.3 (21) | 2.78 (1.58, 4.91)** | 1.47 (0.80–2.71) | 2.71 (1.47, 4.97)** | 1.444 (0.78, 2.66) |
Red meat intake (n =545) | |||||
GP-TYAs | 82.2 (264) | 1 | 1 | ||
TYA-CS | 85.1 (148) | 0.56 (0.29, 1.08) | 1 | 0.93 (0.21, 4.08) | 1 |
TYA-CP | 81.9 (68) | 1.04 (0.50, 2.13) | 1.84 (0.78–4.32) | 1.59 (0.39, 6.49) | 1.882 (0.79, 4.45) |
Processed meat (n =550) | |||||
GP-TYAs | 52.6 (169) | 1 | 1 | ||
TYA-CS | 39.1 (68) | 1.63 (1.11, 2.40)* | 1 | 5.01 (1.93, 13.01)** | 1 |
TYA-CP | 33.7 (28) | 2.18 (1.30, 3.64)* | 1.33 (0.76, 2.32) | 6.06 (2.32, 15.84)** | 1.195 (0.66, 2.13) |
Fruit and veg (n =527) | |||||
GP-TYAs | 25.2 (81) | 1 | 1 | ||
TYA-CS | 15.5 (27) | 1.73 (0.90, 3.31) | 1 | 2.11 (0.69, 6.43) | 1 |
TYA-CP | 15.7 (13) | 1.62 (0.99, 2.65) | 1.06 (0.51, 2.20) | 2.15 (0.68, 6.75) | 0.961 (0.45, 2.02) |
Smoking (n =533) | |||||
GP-TYAs | 86.0 (276) | 1 | 1 | ||
TYA-CS | 79.9 (139) | 1.95 (0.91, 4.18) | 1 | 2.1 (0.94, 4.68) | 1 |
TYA-CP | 79.5 (66) | 1.04 (0.46, 2.36) | 0.53 (0.19, 1.44) | 1.1 (0.49, 2.73) | 0.533 (0.19, 1.46) |
Alcohol consumption (units) (n =490) | |||||
GP-TYAs | 80.4 (82) | 1 | 1 | ||
TYA-CS | 77.9 (109) | 0.94 (0.39, 2.25) | 1 | 0.92 (0.36, 2.35) | 1 |
TYA-CP | 86.4 (51) | 0.22 (0.02, 1.68) | 0.23 (0.02, 1.90) | 0.19 (0.02, 1.58) | 0.209 (0.02, 1.73) |
Binge drinking (n =523) | |||||
GP-TYAs | 45.1 (46) | 1 | 1 | ||
TYA-CS | 29.3 (41) | 3.06 (2.03, 4.61)** | 1 | 3.26 (2.12, 5.02)** | 1 |
TYA-CP | 50.8 (30) | 1.1 (0.68, 2.02) | 0.38 (0.21, 0.69) | 1.26 (0.72, 2.2) | 0.404 (0.21, 0.74)** |
Perception of current health behaviour
Reported perception of current lifestyle | TYA cancer patients % (n) | TYA cancer survivors % (n) | General population TYAs % (n) | Between group differences |
---|---|---|---|---|
Weight status | ||||
I think I should be trying to lose weight | 36.1 (30) | 45.4 (79) | 34 (109) | p =0.050 |
I think I should be trying to gain weight | 14.5 (12) | 10.3 (18) | 10.6 (34) | |
I don’t think I need to change my weight | 41.0 (34) | 40.2 (70) | 40.8 (131) | |
Don’t know | 7.2 (6) | 3.4 (6) | 10.9 (35) | |
Missing data | 1.2 (1) | 0.6 (1) | 3.7 (12) | |
Physical activity | ||||
I think I should do more physical activity | 70.7 (58) | 71.1 (123) | 67.0 (215) | p =0.141 |
I think I should do less physical activity | 2.4 (2) | 2.3 (4) | 2.5 (8) | |
I don’t think I need to change my physical activity | 20.7 (17) | 25.4 (44) | 24.9 (80) | |
Don’t know | 6.1 (5) | 0 (0) | 4.4 (14) | |
Missing data | 0 (0) | 1.2 (2) | 1.2 (4) | |
Diet | ||||
I think I should have a healthier diet | 55.8 (43) | 53.2 (82) | 53.3 (171) | p =0.151 |
I don’t think I need to change my diet | 31.2 (24) | 39.6 (61) | 33.0 (106) | |
Don’t know | 9.1 (7) | 4.5 (7) | 10.6 (34) | |
Missing data | 2.6 (2) | 1.9 (3) | 3.1 (10) | |
Alcohol consumption | ||||
I think I should drink less | 6 (5) | 5.7 (10) | 9.3 (30) | p =0.915 |
I don’t think I need to change my alcohol consumption | 62.7 (52) | 63.8 (111) | 76 (244) | |
Don’t know | 8.4 (7) | 6.9 (12) | 9.3 (30) | |
Missing data | 21.9 (19) | 23.6 (41) | 5.3 (17) | |
Change in lifestyle since cancer | ||||
Weight status | ||||
More than before cancer | 50.6 (42) | 59.2 (103) | – | p =0.245 |
About the same as before cancer | 24.1 (20) | 23.0 (40) | – | |
Less than before cancer | 24.1 (20) | 17.8 (31) | – | |
Missing data | 1.2 (1) | 0 (0) | – | |
Physical activity | ||||
More than before cancer | 16.9 (14) | 28.9 (50) | – | p =0.003 |
About the same as before cancer | 14.5 (12) | 25.4 (44) | – | |
Less than before cancer | 66.3 (55) | 44.5 (77) | – | |
Missing data | 2.4 (2) | 1.2 (1) | – | |
Diet | ||||
Healthier than before cancer | 31.2 (24) | 42.2 (65) | – | p =0.053 |
About the same as before cancer | 44.2 (34) | 44.2 (68) | – | |
Less healthy than before cancer | 22.1 (17) | 11 (17) | – | |
Missing data | 1.6 (2) | 2.6 (4) | – | |
Alcohol consumption | ||||
More than before cancer | 8.4 (7) | 27.0 (47) | – | p <0.001 |
About the same as before cancer | 27.7 (23) | 28.2 (49) | – | |
Less than before cancer | 41.0 (34) | 20.1 (35) | – | |
Missing data | 22.9 (19) | 24.7 (43) | – | |
Smoking* | n =8 | n =9 | ||
Tried to quit since cancer diagnosis | 50.0 (4) | 44.4 (4) | – | p =0.539 |
Not tried to quit since cancer diagnosis | 50.0 (4) | 55.6 (5) | – |