Lifestyle differences between rare and common cancer survivors: a population-based registry study

Practicing a healthy lifestyle can be challenging for rare cancer (RC) survivors, as they may experience a more complex disease trajectory and higher psychosocial burden, compared to common cancer (CC) survivors. This study aimed to assess lifestyle differences between RC and CC survivors, and to evaluate which sociodemographic and clinical factors are associated with RC survivors’ lifestyle. Cross-sectional data on five lifestyle factors were extracted from the PROFILES registry: alcohol consumption, tobacco smoking, body mass index (BMI), physical activity, and dietary changes. For each behaviour, a ‘healthy’ and ‘unhealthy’ score was defined, and a total lifestyle score was generated. Univariate and multivariate linear regression analyses were performed. Lifestyle factors differed significantly between RC (n=2,294) and CC (n=12,212) survivors, with RC survivors classified as healthier regarding alcohol consumption, BMI, physical activity, and dietary changes, yet, unhealthier regarding tobacco smoking (all: p<0.05). RC survivors showed a higher total lifestyle score than CC survivors (p<0.001), and healthier lifestyles in RC survivors were found in, e.g., females and those having a medium or high socioeconomic status; unhealthier lifestyles were found in those aged 40-64 years (all: p<0.05). Except for tobacco smoking, RC survivors were found to have a healthier lifestyle and a higher total lifestyle score compared with CC survivors. Although findings are relatively positive for RC survivors, factors associated with unhealthy behaviour should be acknowledged and acted upon by healthcare professionals, and lifestyle programs in which RCs’ needs are being met, specifically for tobacco smoking, should be developed. • Differences in lifestyle between rare and common cancer survivors exist. • Sociodemographic factors are associated with rare cancer survivors’ lifestyle. • Rare cancer survivors may adopt lifestyle changes pre-diagnosis due to symptoms. • Rare cancers’ tailored programs are needed, especially for smoking cessation.