Health-risk behaviours among adolescent survivors of childhood cancer

Background. The purpose of the study was to investigate smoking, alcohol use, illicit drug use and sexual risk taking among adolescent survivors of childhood cancer treated in Australia. Procedure. A comparison study selecting on exposure (cancer vs. healthy) and administering a branched computerised questionnaire assessing health-risk behaviour, predominately by telephone interview. One hundred fifty-three adolescent survivors of childhood cancer were compared with age matched healthy adolescents drawn from one of two Australian population based surveys of adolescent health. Behaviours assessed were tobacco use, alcohol use, binge drinking, cannabis use, pain reliever use, other illicit drug use and unprotected sex. Results. Compared to their healthy peers, younger survivors (13- to 17-years) were at an increased risk of reporting pain reliever use (OR=2.1) for non-medical purposes, but lower risk of binge drinking (OR=0.20), cannabis use (OR=0.25), other illicit drug use (OR=0.31), tobacco use (OR=0.38) and alcohol use (OR=0.44). Older survivors (18- to 24-years) were at an increased risk of reporting alcohol use (OR 1.5), but at lower risk of reporting cannabis use (OR=0.27), other illicit drug use (OR=0.44) and tobacco use (OR=0.47). Survival analysis using the full adolescent survivor cohort (13- to 24-years) showed that the age of onset of tobacco use was later for cancer survivors (hazard ratio HR=0.65). Conclusion. Adolescent cancer survivors show reduced involvement in most health-risk behaviours, with the exception of pain reliever use among younger survivors and alcohol use among the older survivors. Although risks were reduced a substantial proportion of survivors engage in these behaviours.