Healthy lifestyle maintenance among breast and colorectal cancer survivors: associations with fear of recurrence and emotional distress

Cancer survivors face challenges in maintaining a healthy lifestyle after treatment. Maintaining a healthy lifestyle can help delay cancer recurrence, improve quality of life, and even extend survival. This study compared levels of healthy lifestyle maintenance by cancer type and sex among breast cancer survivors (BCS) and colorectal cancer survivors (CRCS) and assessed the mediating roles of fear of cancer recurrence and emotional distress in the association between physical cancer-related symptoms and healthy lifestyle maintenance. This cross-sectional study involved 175 BCS and 189 CRCS aged 31–77, 2–5 years after diagnosis. Data were collected online using structured questionnaires. Univariate general linear models and multigroup path analysis with structural equation modeling were conducted. BCS reported higher physical activity and a healthier diet than CRCS. Women in both groups reported higher levels of healthy diet and physical activity. Further analysis of lifestyle by type of cancer and sex, controlling for demographic and cancer-related variables, showed no significant effect of sex. Physical cancer-related symptoms among BCS were associated with a healthy diet via the mediation of fear of recurrence. CRCS had no indirect associations with a healthy diet. Maintenance of a healthy lifestyle differed by breast or colorectal cancer and was not explained by sex, warranting further investigation. Additionally, the study highlighted the role of fear of recurrence as a barrier to healthy lifestyle maintenance. These findings highlight the need for tailored interventions to address the specific challenges faced by BCS and CRCS in promoting a healthy lifestyle. Interventions should focus on the joined effects of physical cancer-related symptoms and fear of recurrence on maintaining a healthy lifestyle.