Transcript Health-Risk Behaviors in Adolescents with Cancer

Health-Risk Behaviors in Adolescents with Cancer
M.Y. Carpentier, L.L. Mullins, T.D. Elkin, & C. Wolfe-Christensen
OVERVIEW
• A majority of adolescents on treatment for cancer
will enter survivorship. However, they will continue
to be at-risk for the development of second
malignancies, a risk which likely to be magnified
with engagement in health-risk behaviors.
• To date, no research has examined prevalence
rates of health-risk behaviors among adolescents
currently on treatment for cancer.
• By obtaining an earlier snapshot of what these
behaviors look like prior to entering survivorship,
we can better inform intervention efforts.
• Therefore, the purpose of the current study was to
assess prevalence rates of multiple health-risk
behaviors (i.e., tobacco, alcohol, and other drug
use; sexual risk-taking) among adolescents
currently on treatment for cancer, as compared to
normative rates for healthy U.S. adolescents.
METHODOLOGY
• Forty-two adolescents ages 12 to 19 years (15
males, 27 females), who primarily self-identified as
Caucasian (64.3%), participated in the current
study.
• Primary cancer diagnosis was leukemia (42.9%),
followed by sarcoma (28.6%).
• Mean age at participation was 15.9 years, while
mean time since diagnosis was 15.6 months.
• Adolescents completed the 2005 National Youth
Risk Behavior Survey (CDC, 2004) as part of a
larger battery.
• Prevalence rates were compared to YRBS norms
using a one-sample t-test for comparing data to a
known proportion.
RESULTS
DISCUSSION
Participants reported significantly lower rates of lifetime (z = -2.38, p = .01)
and current cigarette use (z = -2.81, p = .00), lifetime (z = -4.25, p = .00)
and current alcohol use (z = -5.01, p = .00), current episodic heavy drinking
(z = -3.49, p = .00), lifetime (z = -2.85, p = .00) and current marijuana use (z
= -2.85, p = .00), lifetime cocaine use (z = -1.91, p = .03), and lifetime
inhalant use (z = -1.92, p = .03), as compared to healthy peers.
Participants reported significantly lower rates of lifetime (z = -2.39, p = .01)
and early-onset sexual intercourse (z = -1.64, p = .05) and alcohol/drug use
prior to last sex (z = -3.54, p = .00), as compared to healthy peers.
Prevalence of Health-Risk Behaviors in Adolescents with Cancer (AWC) as
Compared to Healthy U.S. Adolescents
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Behavior
AWC
U.S.
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Tobacco, Alcohol, & Other Drug Use
Lifetime cigarette use
Current cigarette use
Lifetime alcohol use
Current alcohol use
Current episodic heavy drinking
Lifetime marijuana use
Current marijuana use
Lifetime cocaine use
Current cocaine use
Lifetime inhalant use
Lifetime heroin use
Lifetime methamphetamine use
Lifetime ecstasy use
Lifetime hallucinogenic drug use
35.7*
4.8**
45.2*
4.8*
2.4*
16.7*
2.4*
0.0*
0.0*
2.4*
0.0
2.4
2.4
2.4
54.3
23.0
74.3
43.3
25.5
38.4
20.2
7.6
3.4
12.4
2.4
6.2
6.3
8.5
Sexual Risk-Taking
Lifetime sexual intercourse
28.6*
46.8
Sexual intercourse prior to age 13
0.0*
6.2
Sexual intercourse with 4 or more partners
25.0
14.3
Currently sexually active
50.0
33.9
Alcohol/drugs prior to last sex
0.0*
23.3
Used a condom at last sex
41.7
62.8
Used birth control pills at last sex
33.0
17.6
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Note. Lifetime use = Ever tried or had; Current use = More than once in past 30
days; Episodic heavy = At least 5 or more drinks in a row at least once in past 30
days; *p < .05.
• Adolescents with cancer demonstrate lower rates of
lifetime and current tobacco, alcohol, and other drug use
as compared to healthy peers, with most of these
differences emerging within the statistically significant
range.
• Adolescents with cancer also demonstrate decreased
lifetime and early-onset sexual intercourse. However,
among those who have previously engaged in sexual
intercourse, there appeared to be a trend towards
increased partners, current sexual activity, and lack of
protection at last sexual intercourse.
• Adolescents with cancer are at-risk for the
development of second malignancies, a risk which is
magnified with engagement in health-risk behaviors.
• Through the current study, we have identified an initial
set of modifiable target behaviors that can be addressed
in intervention trials in the hope of improving both longterm survival and quality of life in adolescents who
survive cancer.
CONTACT INFORMATION
For more information, please contact Melissa Y.
Carpentier, Ph.D., Section of Adolescent Medicine,
Indiana University School of Medicine, 410 West 10th
Street, HS 1001, Indianapolis, IN 46202. Phone: (317)
274-8812, Fax: (317) 274-0133, E-mail: [email protected].