Adherence to Secondary Cancer Screening and Lifestyle Habits in Breast Cancer Survivors

Introduction

Breast cancer survivors face an increased risk of secondary primary cancers, making adherence to other screening programs crucial. This study aims to evaluate cervical and colorectal cancer screening adherence and its relationship with cancer-related lifestyle characteristics among these survivors.

Methods

This descriptive study was conducted with 150 women who underwent surgery for breast cancer at a university hospital between May 2024 and May 2025. Data were collected using a survey on screening history and the 8-factor “Cancer-Related Lifestyle Scale” (score range 0-111). Descriptive statistics, Mann-Whitney U, and Kruskal-Wallis tests were used for data analysis.

Results

The mean age was 53.27±12.14 and 70.7% were diagnosed via symptoms. Lifetime cervical screening was 62.7%, while colorectal screening via fecal occult blood test (FOBT) was 27.5% and colonoscopy was 17.5%. FOBT-adherent survivors had significantly higher scores in F2 (Avoidance of risky dietary behaviors), F3 (Preventive health services), F4 (Physical health), F5 (Physical activity), F6 (Balanced nutrition), F7 (Avoidance of harmful substances), and total lifestyle scores (p < 0.05). Cervical screening adherence was significantly associated with higher F3, F5, F8 (Risk-reducing practices), and total scores (p < 0.05). Women performing regular breast self-exams (BSE) scored significantly higher in all lifestyle factors except F6 (Balanced nutrition) compared to those who did not (p < 0.001). Although 77.3% feared a new cancer diagnosis, only 45.3% were recommended other screenings by their physicians.

Conclusions

Adherence to colorectal cancer screening is notably low among breast cancer survivors, and physician guidance remains insufficient. The positive correlation between healthy lifestyle behaviors, BSE awareness, and screening adherence highlights the need for a holistic survivorship approach.

Key messages

• Healthcare professionals should prioritize enhancing screening awareness and promoting lifestyle interventions to ensure early detection of secondary cancers.

• Low adherence to secondary cancer screening reveals a critical gap between survivorship awareness and preventive action among breast cancer survivors