Gynecological cancer survivors' health behaviors and their associations with quality of life

Objectives To evaluate health behaviors (smoking, physical activity, fruit and vegetable intake) and body mass index of gynecological cancer survivors and their association with quality of life. Methods We collected cross-sectional mail survey data from 802 gynecological cancer survivors (56% response rate) The questionnaire included validated measures of health behaviors, quality of life, clinical status, and demographics. Results Depending on gynecological cancer subtype, 61-68% were insufficiently active or sedentary, 19-44% were obese, 31-41% had less than two daily serves of fruit, 82-89% had less than five serves of vegetables and 6-21% smoked. Significantly more endometrial than other cancer survivors were obese (44%; 95% CI 41-47%); smoking was more prevalent among cervical cancer survivors (21%; 95% CI 19-23%). Using general linear modeling we identified a positive linear trend of physical activity level with quality of life (p = 0.039). Being insufficiently active or sedentary was also associated with not meeting the guidelines for fruit and vegetable consumption, with smoking and with overweight/obesity. Conclusions This research demonstrates the importance of integrating physical activity into follow-up of gynecological cancer survivors. Interventions to improve physical activity and test the causal effect of exercise on quality of life are a future research priority.