Health Behaviors Influence Cancer Survival

In this issue of Journal of Clinical Oncology, Duffy et al 1 have provided important evidence of the effect of pretreatment health behaviors on all-cause survival in a prospective cohort study of patients enrolled in the University of Michigan Head and Neck Cancer Specialized Program of Research Excellence (SPORE; Ann Arbor, MI). Analyses of data from 504 participants showed that smoking status (current or former) was the strongest predictor of survival in both univariate and multivariate analyses. In the univariate analysis only, problem drinking, low fruit intake and low level of physical activity negatively affected survival. Low vegetable intake and poor sleep behavior were not significant in either analysis. We comment on the importance of these findings and offer suggestions for additional research, concentrating primarily on smoking behavior, alcohol, diet, and physical activity.