***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: There is limited evidence on the association between adherence to guidelines for cancer survivors and health-related quality of life ( HRQoL ) . In a cross-sectional study of Korean breast cancer survivors , we examined whether adherence to the guidelines of the American Cancer Society ( ACS ) and World Cancer Research Fund/American Institute for Cancer Research ( WCRF/AICR ) for cancer survivors was related to levels of HRQoL , assessed by the Korean version of Core 30 ( C30 ) and Breast cancer module 23 ( BR23 ) of the European Organization for Research and Treatment of Cancer- Quality of Life Question naire ( EORTC-QLQ ) . We included a total of 160 women aged 21 to 79 years who had been diagnosed with breast cancer according to American Joint Committee on Cancer ( AJCC ) stages I to III and had breast cancer surgery at least six months before the interview . Increasing adherence to ACS guidelines was associated with higher scores of social functioning ( p for trend = 0.05 ) , whereas increasing adherence to WCRF/AICR recommendations was associated with higher scores of arm symptoms ( p for trend = 0.01 ) . These associations were limited to those with stage II or III cancer . Diet may be an important factor in relation to quality of life among Korean breast cancer survivors , however our findings warrant further prospect i ve studies to evaluate whether healthy diet improves survivors ’ quality of life Background The relationship between colorectal cancer ( CRC ) risk and physical activity and dietary habits has been well-established , but less is known about the relationship between these behaviours and quality of life ( QOL ) post-diagnosis . Moreover , it is unknown whether this relationship is consistent across cancer stage or treatment setting . Thus , the purpose of this study was to assess current  diet and physical activity behaviour  in CRC survivors receiving systemic chemotherapy  , and to examine potential associations between these behaviours and quality of life . A secondary purpose was to examine the association between social support , diet , and physical activity behaviour in this population . Methods Using a cross-sectional survey , 67 CRC survivors currently receiving chemotherapy in Calgary , Alberta completed the survey package . Measures included demographic and medical data , physical activity levels , diet behaviour , QOL , and social support . Results In a largely metastatic sample ( 63 % ) , approximately half were meeting national dietary guidelines ( 58 % ) , less were meeting national physical activity guidelines ( 26 % ) , and a small number were meeting both ( 17 % ) . However , only 12.3 % ( n = 8) reported completely sedentary behaviour , and 7 of these 8 participants were receiving metastatic treatment . Neither behaviour was significantly associated with QOL or perceived social support . Furthermore , there were no significant QOL differences between those treated with palliative intent or adjuvant therapy . Important group differences emerged between those meeting and not meeting the guidelines , and associations between QOL , age , BMI , and provisions of social support . Conclusion These findings provide insight into lifestyle behaviours of CRC survivors currently receiving systemic chemotherapy , and the differences in perceived QOL as affected by severity of disease and treatment setting . Prospect i ve studies in a larger sample of CRC survivors on chemotherapy are needed to confirm lifestyle behaviour patterns and identify factors related to QOL that are unique to this population , especially during metastatic treatment PURPOSE Single-variable analyses have associated physical activity , diet , and obesity with survival  after breast cancer . This report investigates interactions among these variables . PATIENTS AND METHODS A prospect i ve study was performed of 1,490 women diagnosed and treated for early-stage breast cancer between 1991 and 2000 . Enrollment was an average of 2 years postdiagnosis . Only seven women were lost to follow-up through December 2005 . RESULTS In univariate analysis , reduced mortality was weakly associated with higher vegetable-fruit consumption , increased physical activity , and a body mass index that was neither low weight nor obese . In a multivariate Cox model , only the combination of consuming five or more daily servings of vegetables-fruits , and accumulating 540 + metabolic equivalent tasks-min/wk ( equivalent to walking 30 minutes 6 d/wk ) , was associated with a significant survival advantage ( hazard ratio , 0.56 ; 95 % CI , 0.31 to 0.98 ) . The approximate 50 % reduction in risk associated with these healthy lifestyle behaviors was observed in both obese and nonobese women , although fewer obese women were physically active with a healthy dietary pattern ( 16 % v 30 % ) . Among those who adhered to this healthy lifestyle , there was no apparent effect of obesity on survival . The effect was stronger in women who had hormone receptor-positive cancers . CONCLUSION A minority of breast cancer survivors follow a healthy lifestyle that includes both recommended intakes of vegetables-fruits and moderate levels of physical activity . The strong protective effect observed suggests a need for additional investigation of the effect of the combined influence of diet and physical activity on breast cancer survival Objective With increases in cancer survival , promotion of healthy lifestyle behaviors among survivors is receiving considerable attention . This study compared health behaviors among a large sample of Australian adult cancer survivors with an age- and sex-matched cohort of people with no cancer history . Methods Using the Australian National Health Survey , 968 cancer survivors were identified , and r and omly matched by age and sex to 5,808 respondents without a history of cancer . Six health behaviors were compared  ( smoking , physical activity , servings of vegetables , servings of fruit , alcohol use , skin checks )  , along with  overweight and obesity , using polytomous logistic regression analyses controlling for selected chronic conditions . Models were applied across both groups and by tumor site . Results Compared to the non-cancer comparison group , cancer survivors were significantly more likely to be current ( OR = 1.35 ) smokers , particularly those under 40 years ( OR = 1.69 ) , and more likely to have regular skin checks ( OR = 1.76 ) . Although not significant , there was consistent evidence that cancer survivors were slightly more likely to be overweight or obese ( p = 0.065 ) and have higher levels of alcohol consumption ( p = 0.088 ) . There was no evidence of differences between survivors and controls for levels of physical inactivity , vegetable consumption or fruit consumption .  Women with a history of gynecological cancers were much more likely to be current smokers ( OR = 2.37 ) , while other differences by sex and cancer site were consistent with overall patterns . Cancer survivors were also significantly more likely to report having a range of co-morbid chronic medical conditions . Conclusion Given their increased risk of second cancers and co-morbid chronic conditions , the lack of difference in behavioral risk factors confirms the need for a focus on improving the health behaviors of cancer survivors . Collaborative chronic disease management models may be particularly appropriate in this regard AIMS To assess self-reported lifetime prevalence of cardiovascular disease ( CVD ) among colorectal cancer survivors , and examine the cross-sectional and prospect i ve associations of lifestyle factors with co-morbid CVD . METHODS Colorectal cancer survivors were recruited ( n=1966 ) . Data were collected at approximately 5 , 12 , 24 and 36 months post-diagnosis . Cross-sectional findings included six CVD categories ( hypercholesterolaemia , hypertension , diabetes , heart failure , kidney disease and ischaemic heart disease ( IHD ) ) at 5 months post-diagnosis . Longitudinal outcomes included the probability of developing ( de novo ) co-morbid CVD by 36 months post-diagnosis . Lifestyle factors  included  body mass index , physical activity , television ( TV ) viewing , alcohol consumption and smoking .  RESULTS Co-morbid CVD prevalence at 5 months post-diagnosis was 59 % , and 16 % of participants with no known CVD at the baseline reported de novo CVD by 36 months . Obesity at the baseline predicted de novo hypertension ( odds ratio [OR]=2.20 , 95 % confidence intervals [CI]=1.09 , 4.45 ) and de novo diabetes ( OR=6.55 , 95 % CI=2.19 , 19.53 ) . Participants watching > 4h of TV/d at the baseline ( compared with < 2h/d ) were more likely to develop ischaemic heart disease by 36 months ( OR=5.51 , 95 % CI=1.86 , 16.34 ) . CONCLUSION Overweight colorectal cancer survivors were more likely to suffer from co-morbid CVD . Interventions focusing on weight management and other modifiable lifestyle factors may reduce functional decline and improve survival PURPOSE Colorectal cancer survivors are at risk for poor health outcomes because of unhealthy lifestyles , but few studies have developed translatable health behavior change interventions . This study aim ed to determine the effects of a telephone-delivered multiple health behavior change intervention ( CanChange ) on health and behavioral outcomes among colorectal cancer survivors . METHODS In this two-group r and omized controlled trial , 410 colorectal cancer survivors were r and omly assigned to the health coaching intervention ( 11 theory-based telephone-delivered health coaching sessions delivered over 6 months focusing on physical activity , weight management , dietary habits , alcohol , and smoking ) or usual care . Assessment of primary ( ie , physical activity [ Godin Leisure Time Index ] , health-related quality of life [ HRQoL ; Short Form-36 ] , and cancer-related fatigue [ Functional Assessment of Chronic Illness Therapy Fatigue Scale ] ) and secondary outcomes ( ie , body mass index [ kg/m(2 ) ] , diet and alcohol intake [ Food Frequency Question naire ] , and smoking ) were conducted at baseline and 6 and 12 months . RESULTS At 12 months , significant intervention effects were observed for moderate physical activity ( 28.5 minutes ; P = .003 ) , body mass index ( -0.9 kg/m(2 ) ; P = .001 ) , energy from total fat ( -7.0 % ; P = .006 ) , and energy from saturated fat ( -2.8 % ; P = .016 ) . A significant intervention effect was reported for vegetable intake ( 0.4 servings per day ; P = .001 ) at 6 months . No significant group differences were found at 6 or 12 months for HRQoL , cancer-related fatigue , fruit , fiber , or alcohol intake , or smoking . CONCLUSION The CanChange intervention was effective for improving physical activity , dietary habits , and body mass index in colorectal cancer survivors . The intervention is translatable through existing telephone cancer support and information services in Australia and other countries Purpose Differences in health status and behavioral risk factors may explain racial/ethnic breast cancer disparities . We examined racial/ethnic differences in health status and behaviors among female breast cancer survivors compared to females without breast cancer . Methods Using cross-sectional data from the 2009 Behavioral Risk Factor Surveillance System , a national state-based , r and om sample telephone survey , we explored differences in self-rated health , obesity and selected behaviors ( physical activity , smoking , alcohol use , fruit , and vegetable consumption ) among females aged 18 years and older , who reported a previous breast cancer diagnosis ( survivors , n = 10,035 ) and those who reported no breast cancer history ( n = 234,375 ) by race/ethnicity . Adjusted prevalences of health status and behaviors , accounting for sociodemographics , comorbidities and health care access , were estimated by race/ethnicity . Results Compared to all other racial/ethnic groups , more white females reported heavy alcohol consumption and more black females reported obesity regardless of their breast cancer status . Among breast cancer survivors , more whites ( 33.7 % ) were former smokers compared to blacks ( 24.5 % ) , “ others ” ( 20.5 % ) , and Hispanics ( 16.2 % ) ( p = 0.001 ) . Racial/ethnic differences in obesity also varied by reported time since diagnosis ( p value = 0.018 ) . Among long-term survivors ( diagnosed > 5 years before interview ) , more black survivors ( 34.8 % ) reported obesity compared to white survivors ( 23.0 % ) . Also , among “ other ” race survivors , long-term survivors ( 22.0 % ) reported more obesity than survivors diagnosed less than 5 years before interview ( 7.8 % ) . Conclusions These findings suggest opportunities to increase health behaviors and reduce racial disparities among breast cancer survivors . Implication s for Cancer SurvivorsEngaging in healthy behaviors can play a significant role in enhancing health outcomes and quality of life of breast cancer survivors . More research is needed to better underst and racial differences in obesity , smoking and alcohol consumption in order to develop effective , culturally appropriate interventions to promote a healthy lifestyle after a breast cancer diagnosis Purpose The effectiveness of survivorship care plans has not been widely tested . We evaluated whether a one-time brief lifestyle consultation as part of a broader survivorship care plan was effective at changing diet and lifestyle patterns . Methods A diverse sample of women with stage 0-III breast cancer were r and omized to control or intervention groups within 6 weeks of completing adjuvant treatment . Both groups received the National Cancer Institute publication , “ Facing Forward : Life after Cancer Treatment . ” The intervention group also met with a nurse ( 1 h ) and a nutritionist ( 1 h ) to receive personalized lifestyle recommendations based 
    Output:
    
Conclusion  Adherence to physical activity , dietary , and multiple lifestyle behaviours  recommendations was low amongst cancer survivors .
Recent cancer survivors were relatively more adherent to WCRF/AICR recommendations compared to long-term survivors .
Implication s for Cancer SurvivorsHealth promotion programs help support healthy lifestyle behaviours of cancer survivors .