Only 4% of people who have had cancer follow the American Cancer Society’s recommendations for nutrition, healthy weight, physical activity and alcohol consumption, according to study results published in JAMA Oncology.

The American Cancer Society (ACS) offers guidelines for nutrition and physical activity aim to lower morbidity and improve mortality among people with a history of cancer. They emphasize a balanced diet, maintaining a healthy weight, abstinence from alcohol and regular exercise.

Carter Baughman, MD, of Beth Israel Deaconess Medical Center and colleagues sought to understand the extent to which people who completed cancer treatment adhere to these recommendations. They assessed adherence to physical activity recommendations, alcohol abstinence, maintaining a healthy weight and fruit and vegetable intake.

The research team used data from the Behavioral Risk Factor Surveillance System, specifically surveys completed during 2017, 2019 and 2021. The final study population included 10,020 people who had completed cancer therapy in the year prior to the survey. Just over half were women, and the average age was 64 years. Of this group, 9,121 people (91%) responded to questions assessing adherence on all four measures.

Of the 9,121 respondents, only 365 people (4%) followed ACS guidelines in all four areas. On average, people followed at most two recommendations. When measuring adherence, the researchers observed that 72% of respondents regularly exercised, 68% did not have obesity, 50% abstained from alcohol and 12% consumed the recommended amount of fruits and vegetables. Women, older people and Black people were more likely to follow the guidelines, as were those who had a higher education level and lived in the Western United States.

What’s more, the researchers found that people who had completed cancer treatment were less likely to follow healthy lifestyle recommendations than people who had not been diagnosed with cancer in the general population.

“The findings suggest that there remains a gap between ideal and observed adherence to healthy behavior guidelines among cancer survivors,” they wrote. “Improved understanding of guideline adherence and its determinants may guide oncologists and general internists in providing recommendations for their patients who have completed cancer treatments.”

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