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Cancer Causes Control. 2014 Jan;25(1):99-110. doi: 10.1007/s10552-013-0313-y. Epub 2013 Oct 25.

Lifestyle factors and health-related quality of life in colorectal cancer survivors.

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Institute of Epidemiology, Christian-Albrechts University of Kiel, Campus Kiel, UKSH, Arnold-Heller-Str. 3, Haus 1, 24105, Kiel, Germany,



This study investigates the association between a postdiagnosis lifestyle score and health-related quality of life (HrQol) in long-term colorectal cancer (CRC) survivors.


A cross-sectional study of 1,389 long-term CRC survivors in Northern Germany was analyzed. On average 7.2 years after CRC diagnosis, HrQol was assessed with the EORTC QLQ-C30, and lifestyle factors, including weight, height, diet, physical activity, and smoking were obtained using self-administered questionnaires. A lifestyle score (BMI <30 kg/m², healthy diet, recreationally active, and not smoking) was applied. Participants were categorized in adhering to at most one, two, three, or all recommended lifestyle factors, categorizing unfavorable behaviors with 0 and favorable with 1 point. Multivariable logistic regression models were used to investigate the association between the lifestyle score and HrQol as a binary variable.


Approximately 10 % had at most one, 30 % two, 38 % three, and 23 % all favorable factors. Compared to participants with one or zero factors, the odds ratio (OR) for a low global HrQol (gHrQol) decreased with stronger adherence to the score. The OR (95% CI) for a low gHrQol was 0.50 (0.33-0.76) for participants with all favorable lifestyle factors compared to participants with one or zero. Clinical and socio-demographic factors had little impact on these associations, with exception of living arrangement which showed a statistically significant interaction. Associations were stronger for functioning domains, representing mobility rather than mental health.


Favorable lifestyle behaviors might be associated with HrQol in CRC long-term survivors. More research in prospective studies is needed.

[Indexed for MEDLINE]

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