Dear Colleagues,

The special issue of IJERPH suggest focusing on health behaviors and lifestyle changes.

Over the past decades, the incidence of most cancers has increased in developed countries. At the same time, earlier diagnoses and more effective treatments have led to increased survival rates for most cancers. As a result, the population of cancer survivors is steadily increasing. The growing number of studies on cancer survivorship in the industralised countries has shown that many survivors have to face psychological, physical and social challenges that may impact their daily lives and their quality of life, years after cancer diagnosis, especially among younger adults. It’s today well known most of cancer survivors experience deterioration in the quality of life, frequent sexual disorders even in patients suffering of cancer outside the genital area, but also a negative impact of the disease on employment status and social connection.

Specific health risk enhanced social vulnerability of cancer survivors. Furthermore, previous surveys have shown that they were at an increased risk of developing second primary cancers, osteoporosis, obesity, cardiovascular disease, diabetes and functional decline. These risks may be related to cancer treatment, genetic predisposition but also and/or lifestyle factors. Particularly, second cancers may occur in the same organ site (breast or colorectal for example), but also in other sites, with more frequent associations like, for example, bladder cancer after a first head and neck, oesophagus, larynx or kidney cancer, or prostate cancer after a first thyroid cancer. A set of non-healthy behaviors induce an increasing risk of relapse or to develop a second primary cancer. To continue tobacco use, alcohol drinking, after a lung a second cancer diagnosis leads to a decrease in treatment response, an increase of the risk of second primary cancer and an increase in toxicity and comorbidity. Obesity has also been related with increased of primary cancer incidence, in particular after a breast cancer and previous studies determined that low-fat dietary interventions could decrease breast cancer recurrence. Finally, regular physical activity has been associated with cancer prevention and decrease of the risks of recurrence and mortality, particularly in the context of breast and colorectal cancers.

Why propose a special issue dealing with this topic ?

Dissemination of knowledge based on studies among social, cultural and economic factors associated with health behaviors and associated changes among cancer survivors could help public health authorities, health professionals and researchers to manage social and health vulnerability of growing population of cancer survivors. It will give the opportunity to better understand how cancer survivors modify their risky behaviors after cancer diagnosis. It can help to identify which factors will contribute (or not) to lifestyle behaviors changes among cancer survivors and on the contrary, which barriers exist against changes for healthy behaviors.

To summarize, first, this special issue will probably help to face the lack of public health data especially on second cancer prevention practices, more particularly data on health behaviors of cancer survivors. Indeed, it can increase awareness among patients and health care givers of the important need for tertiary prevention, such as regular screening for second cancers, and help health authorities to implement new prevention strategies towards cancer survivors, taking into account all factors identified.

Secondly, it will give us the possibility to document the length of social and cultural dimension in numerous aspects of lifestyle and health behaviors changes after cancer diagnosis.

Selection of eligible papers will be based on three priorities.

• Public health, SHS and social epidemiology papers will be requested.
• Due comparatively to the little research published on coping with cancer among ethnic or cultural minorities at time of diagnosis, during treatment or in the course of survivorship, attention will be paid to studies that investigated this particular thema.
• Results of interventional research finding and community-based intervention will be appreciated.

Dr. Marc Karim Bendiane
Guest Editor

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• Cancer Survivorship
• Health Behaviors
• Tertiary prevention
• lifestyle
• prevention