Health behavior changes and mortality among South Korean cancer survivors

Wonjeong Jeong, Eun Cheol Park, Chung Mo Nam, Sohee Park, Jin Young Nam, Sung In Jang

Research output: Contribution to journalArticlepeer-review


Considering the rapid growth in the number of cancer survivors, the successful management of their health behaviors requires further attention. However, there are lack of information about cancer survivors’ health behaviors and the risk of mortality using Korean cohort data. This study aimed to examine the effects of health behavior changes on mortality among cancer survivors and to develop a validated nomogram. This cohort study was conducted using claims data. Data from adult cancer survivors from the National Health Insurance Service–National Sample Cohort, conducted between 2002 and 2015, were included. Individuals who were alive for five years after their cancer diagnosis were defined as cancer survivors. Cox proportional-hazards regression was used to estimate the target associations. Discrimination (Harrell’s C-index) and calibration (Hosmer–Lemeshow test) were employed to validate the nomogram. Data from 9300 cancer survivors were used for analysis. Compared to non-smokers, those who started or quit smoking had a higher risk of all-cause mortality. Those who were physically inactive had a higher risk of all-cause mortality than those who were continuously active. In the nomogram, the C-index value was 0.79 in the training data and 0.81 in the testing data. Hosmer–Lemeshow test was not significant, demonstrating a good fit. We found that individuals with unhealthy behaviors had a higher risk of mortality, thereby highlighting the importance of managing health behaviors among cancer survivors. The development of a validated nomogram may provide useful insights regarding official policies and existing practices in healthcare systems, which would benefit cancer survivors. Our study could provide the evidence to inform the priority of guideline for managing the health behavior among cancer survivors.

Original languageEnglish
Article number16011
JournalScientific reports
Issue number1
Publication statusPublished - 2022 Dec

Bibliographical note

Funding Information:
This paper is excerpted from the doctoral dissertation of Wonjeong Jeong in 2022. We would like to thank colleagues from the Department of Public Health, Graduate School of Yonsei University, who provided their advice in the preparation of this manuscript.

Funding Information:
This work was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI20C1130).

Publisher Copyright:
© 2022, The Author(s).

All Science Journal Classification (ASJC) codes

  • General


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