{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:51:17Z","timestamp":1791352277460,"version":"4.3.1"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>With this study, we aimed to investigate the longitudinal relationships between lifestyle behaviors and physical health in childhood, adolescent, or young adult (CAYA) cancer survivors attending the Long\u2010Term Survivor's Clinic (LTSC) in Calgary, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Survivors attended the LTSC once or twice a year and completed a questionnaire at each visit. Among survivors of any cancer diagnosis who were aged \u2265\u200911\u2009years at the time of assessment, physical health was captured using two outcomes: the number of self\u2010reported physical health problems and the number of physical health\u2010related medications used. Self\u2010reported lifestyle behaviors, including physical activity, alcohol, tobacco, and cannabis use, and sleep quality were scored as healthy (1) or unhealthy (0), and combined into a sum score ranging from 0 to 5. Multivariable, generalized linear mixed models (GLMM) were estimated to assess the association between lifestyle behaviors (sum score and individual behaviors) and physical health outcomes, irrespective of time. To address our second research question, cross\u2010lagged GLMMs, incorporating a time component, were estimated to assess directionality between lifestyle sum score and the number of physical health problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 766 responses from 312 CAYA cancer survivors (median age at follow\u2010up 23.8\u2009years; 49% male; 37% diagnosed with leukemia) were included. A healthier lifestyle sum score and sufficient physical activity were associated with fewer physical health problems (estimate \u22120.15, SE 0.06,\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value 0.02 and estimate \u22120.23, SE 0.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value 0.04, respectively). No significant associations were found between lifestyle and the number of medications used. Lifestyle behaviors at an earlier time did not predict better physical health at a later time and vice versa.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings confirm an association between a healthy lifestyle and fewer physical health problems. Additional studies are warranted to further elucidate directional pathways between a survivor's lifestyle and physical health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72324","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:35:49Z","timestamp":1791351349000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lifestyle Behaviors and Physical Health in Canadian Childhood, Adolescent, and Young Adult Cancer Survivors"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6227-3472","authenticated-orcid":false,"given":"Selina R.","family":"van den Oever","sequence":"first","affiliation":[{"name":"Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"},{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5891-2959","authenticated-orcid":false,"given":"Ismay A. E.","family":"de Beijer","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4134-9482","authenticated-orcid":false,"given":"Oluwaseyi A.","family":"Lawal","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heide T.","family":"Adham","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamilore","family":"Ashofor","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5358-5928","authenticated-orcid":false,"given":"Amanda","family":"Button","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3333-9045","authenticated-orcid":false,"given":"Jenny","family":"Duong","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Giles","sequence":"additional","affiliation":[{"name":"The Long\u2010Term Survivor's Clinic Alberta Children's Hospital  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7422-3248","authenticated-orcid":false,"given":"Leontien C. M.","family":"Kremer","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"},{"name":"University Medical Center Utrecht Wilhelmina Children's Hospital  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2253-2115","authenticated-orcid":false,"given":"Helena","family":"van der Pal","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Reynolds","sequence":"additional","affiliation":[{"name":"The Long\u2010Term Survivor's Clinic Alberta Children's Hospital  Calgary Alberta Canada"},{"name":"Department of Family Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0385-4999","authenticated-orcid":false,"given":"Rachel M.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4459-7799","authenticated-orcid":false,"given":"Saskia M. F.","family":"Pluijm","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3076-9676","authenticated-orcid":false,"given":"Fiona M.","family":"Schulte","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"issue":"5","key":"e_1_2_14_2_1","doi-asserted-by":"crossref","first-page":"e276","DOI":"10.1093\/oncolo\/oyad004","article-title":"Childhood Cancer Survivors' Reported Late Effects, Motivations for Seeking Survivorship Care, and Patterns of Attendance","volume":"28","author":"Signorelli C.","year":"2023","journal-title":"Oncologist"},{"issue":"3","key":"e_1_2_14_3_1","first-page":"363","article-title":"Cardiac Disease in Childhood Cancer Survivors: Risk Prediction, Prevention, and Surveillance: JACC CardioOncology State\u2010Of\u2010The\u2010Art Review","volume":"2","author":"Leerink J. 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