Abstract
BACKGROUND: It is important to understand how health behaviors, and beliefs about health behaviors and cancer risk, vary by sociodemographic factors. METHODS: The Health Information National Trends Survey - Surveillance, Epidemiology, and End Results study sampled US cancer survivors in 2021. We used weighted logistic regression to examine associations between sociodemographic factors, health behavior guideline adherence, and beliefs about health behaviors and cancer risk. RESULTS: Among 1134 cancer survivors, only 4% were current smokers, but 48% consumed alcohol and only 43% met aerobic exercise guidelines and 31% met strength training guidelines. Alcohol use was more common among males [vs. females, odds ratio (OR): 1.55; 95% confidence interval (CI): 1.12, 2.14], employed cancer survivors (vs. retired OR: 1.74; 95% CI: 1.07, 2.84), and those with higher incomes (<$50,000 vs. $100,000+ (ref.) OR: 0.58; 95% CI: 0.36, 0.94). Cancer survivors less likely to meet aerobic exercise guidelines included those who were not retired or employed (e.g. disabled; vs. retired OR: 0.49; 95% CI: 0.28, 0.86), with incomes <$50,000 (vs. $100,000+ OR: 95% CI: 0.50; 95% CI: 0.32, 0.78), and residing in non-metropolitan areas (vs. metropolitan with 1 + million residents, OR: 0.56; 95% CI: 0.38, 0.81). Females and retired cancer survivors were less likely to meet strength training guidelines (males vs. females (ref.) OR: 1.62; 95% CI: 1.23, 2.12; employed vs. retired (ref.) OR: 1.67; 95% CI: 1.04, 2.66). Lower education was strongly associated with beliefs that cancer risk is outside individual control (OR's: 1.73-3.85). Beliefs about health behaviors and cancer risk were not associated with health behavior guideline adherence. CONCLUSIONS: Smoking was uncommon in this sample of cancer survivors, but many reported alcohol use and did not meet exercise guidelines. Patterns of sociodemographic factors differed by behavior. Alcohol use was more common among males and those with higher incomes. Cancer survivors with lower incomes and residing in non-metropolitan areas had the highest need for physical activity interventions.