br Demographic and socioeconomic characteristics included we
Demographic and socioeconomic characteristics included were age (40−49, 50−59, 60−79 years), education level (below high school, high school, above high school), monthly household income (<$1,500, $1,500−$2,999, $3,000−$3,999, ≥$4,000; US$1=1,000 Korean Won), current employment condition (yes/no), any chronic disease in the past diagnosed by a physician (yes/no), and self-rated health (healthy, normal, unhealthy). Repro-ductive factors were additionally considered for female participants, including number of children (zero, one to two, three to four, five or more) and menopausal status (yes/no). Missing values in demo-graphic and SES variables were treated with dummy coding.
All analyses were conducted separately for males and females, and differences in modifiable risk factors for those sybr safe with any FHCA and those with each cancer type of FHCA (gastric, liver, colorec-tal, breast, cervical, lung, thyroid, and others) compared with those without any type of FHCA were assessed. Baseline sociode-mographic characteristics of participants with and without FHCA and each cancer type of FHCA were presented as numbers and percentages, and were compared using the chi-square test.
To identify whether FHCA and each type of FHCA were inde-pendently associated with each modifiable risk factor (current smoking, currently drinking alcohol, physical inactivity, obesity, and abdominal obesity), multivariate logistic regression was con-ducted. The included covariates were age, education, monthly household income, job status, self-rated health, chronic disease, other health behaviors, and, in the case of females, menopause sta-tus and number of children. Dummy variables for missing data on
demographic and SES variables were included in multivariate logistic regression. The results were presented as AORs and 95% CIs. Data analyses were performed in 2018 using SAS, version 9.3.
The baseline sociodemographic characteristics according to FHCA and cancer type of FHCA are shown by sex in Tables 1 and 2. In male participants with an FHCA, dis-tributions of all covariates were significantly different compared with those without an FHCA (p<0.05). In females, distributions of all covariates except meno-pausal status were significantly different between those with and without an FHCA.
Comparing the relationship between FHCA and health behaviors by sex (Tables 3 and 4), male subjects with an FHCA were less likely to smoke than those with-out FHCA, especially in those with stomach and colorec-tal FHCA, but female subjects with an FHCA were more likely to smoke than those without an FHCA, especially in those with breast and lung FHCA. For physical inac-tivity, no significant relationship existed in males, but females with an FHCA were less likely to be physically inactive. For obesity, males with an FHCA were less likely to be obese, but females with an FHCA had no sig-nificant association with obesity.
The current study results indicate that the prevalence of modifiable cancer risk factors, including current smok-ing, drinking alcohol, physical inactivity, obesity, and abdominal obesity, were different according to the pres-ence of FHCA, the cancer type of FHCA, and sex. Inter-estingly, different associations were observed between FHCA and these factors by sex. Males with an FHCA were less likely to be a current smoker, but females with an FHCA were more likely to be a current smoker com-pared with those without an FHCA.
Previous studies that examined relationships between modifiable health behaviors and FHCA have consistently shown that people with FHCA did not have better pre-ventive lifestyle behaviors, despite being more likely to undertake screening services.14,17,24 Furthermore, some
studies have shown worse lifestyle behaviors in people with FHCA of the stomach or colorectum.16,25 The cur- rent study showed more unhealthy behaviors in female
participants with FHCA, in agreement with previous studies,16,25,26 suggesting that FHCA is a complex inter-
action between genetic and environmental risk factors, and that there are missed opportunities for improving the health of a population with increased susceptibility of cancer. A study focused on a genetically high-risk group for breast cancer reported that women with strong FHCA of the breast did not show more preventive behaviors. Particularly, women with moderate or high genetic risk were more likely to smoke than women in the low-risk group.17
An unexpected finding of this study was that male par-ticipants with an FHCA showed better health behaviors,