1. OVERVIEW METHODOLOGY RESULTSDISCUSSION CONTACT INFORMATION A majority of adolescents on treatment for cancer will enter survivorship. However, they will continue to be at-risk for the development of second malignancies, a risk which likely to be magnified with engagement in health-risk behaviors. To date, no research has examined prevalence rates of health-risk behaviors among adolescents currently on treatment for cancer. By obtaining an earlier snapshot of what these behaviors look like prior to entering survivorship, we can better inform intervention efforts. Therefore, the purpose of the current study was to assess prevalence rates of multiple health-risk behaviors (i.e., tobacco, alcohol, and other drug use; sexual risk-taking) among adolescents currently on treatment for cancer, as compared to normative rates for healthy U.S. adolescents. For more information, please contact Melissa Y. Carpentier, Ph.D., Section of Adolescent Medicine, Indiana University School of Medicine, 410 West 10 th Street, HS 1001, Indianapolis, IN 46202. Phone: (317) 274-8812, Fax: (317) 274-0133, E-mail: myc@iupui.edu.myc@iupui.edu Participants reported significantly lower rates of lifetime (z = -2.38, p =.01) and current cigarette use (z = -2.81, p =.00), lifetime (z = -4.25, p =.00) and current alcohol use (z = -5.01, p =.00), current episodic heavy drinking (z = -3.49, p =.00), lifetime (z = -2.85, p =.00) and current marijuana use (z = -2.85, p =.00), lifetime cocaine use (z = -1.91, p =.03), and lifetime inhalant use (z = -1.92, p =.03), as compared to healthy peers. Participants reported significantly lower rates of lifetime (z = -2.39, p =.01) and early-onset sexual intercourse (z = -1.64, p =.05) and alcohol/drug use prior to last sex (z = -3.54, p =.00), as compared to healthy peers. Prevalence of Health-Risk Behaviors in Adolescents with Cancer (AWC) as Compared to Healthy U.S. Adolescents ___________________________________________________________________ BehaviorAWCU.S. ___________________________________________________________________ Tobacco, Alcohol, & Other Drug Use Lifetime cigarette use35.7*54.3 Current cigarette use 4.8**23.0 Lifetime alcohol use45.2*74.3 Current alcohol use 4.8*43.3 Current episodic heavy drinking 2.4*25.5 Lifetime marijuana use16.7*38.4 Current marijuana use 2.4*20.2 Lifetime cocaine use 0.0* 7.6 Current cocaine use 0.0* 3.4 Lifetime inhalant use 2.4*12.4 Lifetime heroin use 0.0 2.4 Lifetime methamphetamine use 2.4 6.2 Lifetime ecstasy use 2.4 6.3 Lifetime hallucinogenic drug use 2.4 8.5 Sexual Risk-Taking Lifetime sexual intercourse28.6*46.8 Sexual intercourse prior to age 13 0.0* 6.2 Sexual intercourse with 4 or more partners25.014.3 Currently sexually active50.033.9 Alcohol/drugs prior to last sex 0.0*23.3 Used a condom at last sex41.762.8 Used birth control pills at last sex33.0 17.6 ___________________________________________________________________ Note. Lifetime use = Ever tried or had; Current use = More than once in past 30 days; Episodic heavy = At least 5 or more drinks in a row at least once in past 30 days; *p <.05. Forty-two adolescents ages 12 to 19 years (15 males, 27 females), who primarily self-identified as Caucasian (64.3%), participated in the current study. Primary cancer diagnosis was leukemia (42.9%), followed by sarcoma (28.6%). Mean age at participation was 15.9 years, while mean time since diagnosis was 15.6 months. Adolescents completed the 2005 National Youth Risk Behavior Survey (CDC, 2004) as part of a larger battery. Prevalence rates were compared to YRBS norms using a one-sample t-test for comparing data to a known proportion. Adolescents with cancer demonstrate lower rates of lifetime and current tobacco, alcohol, and other drug use as compared to healthy peers, with most of these differences emerging within the statistically significant range. Adolescents with cancer also demonstrate decreased lifetime and early-onset sexual intercourse. However, among those who have previously engaged in sexual intercourse, there appeared to be a trend towards increased partners, current sexual activity, and lack of protection at last sexual intercourse. Adolescents with cancer are at-risk for the development of second malignancies, a risk which is magnified with engagement in health-risk behaviors. Through the current study, we have identified an initial set of modifiable target behaviors that can be addressed in intervention trials in the hope of improving both long- term survival and quality of life in adolescents who survive cancer. Health-Risk Behaviors in Adolescents with Cancer M.Y. Carpentier, L.L. Mullins, T.D. Elkin, & C. Wolfe-Christensen