Life after cancer: The availability of health behavior recommendations for cancer survivors

Due to advances in early detection and treatment, people are living longer, healthier lives after cancer. Despite the significant improvements in survival rates, survivors are at an increased risk for cancer recurrence and secondary cancer. Promoting healthy-lifestyle behaviors is essential to enhancing long-term health in this population, but it is unclear whether health behavior recommendations specific to cancer survivors are widely available. The goal of the present study was to systematically review health behavior recommendations from major medical organizations for breast, colorectal, prostate, and cervical cancer survivors. Specifically we sought to answer the following: (1) Which behaviors are recommended for cancer survivors to improve and maintain their health after cancer? (2) For which behaviors are clear recommendations lacking? (3) Do organizations agree on recommended behaviors? (4) Are recommendations tailored to specific cancer types available? We searched for cancer prevention recommendations developed specifically for survivors and put forth by nationally known medical organizations as of January 2007 using two methods: (1) a review of the websites of 17 major medical organizations and (2) a systematic literature review. Results indicated that although several organizations have issued health behavior recommendations for cancer survivors, many are vague and not applicable to long-term survivors. Cancer-type-specific recommendations mostly addressed screening practices, while other behaviors such as nutrition and physical activity were neglected. Conflicting recommendations were found concerning cancer screening frequency after treatment. This review identified the need for more specificity and breadth in the content of available health behavior recommendations for cancer survivors.