Purpose Obesity is prevalent in gynecological cancer survivors and is associated with impaired health outcomes. Concerns due to cancer and its treatment may impact changes in lifestyle after cancer. This study aimed to assess the association between cancer-related psychosocial factors and changes in physical activity and diet, 18 months after initial treatment among gynecological cancer survivors. Methods Cross-sectional data from the ROGY Care study were used, including endometrial and ovarian cancer patients treated with curative intent. The Impact of Cancer Scale (IOCv2) was used to assess cancer-related psychosocial factors. Self-reported changes in nutrients/food groups and in physical activity post-diagnosis were classified into change groups (less/equal/more). Multivariable logistic regression models were used to assess associations. Results Data from 229 cancer survivors (59% endometrial, 41% ovarian, mean age 66 ± 9.5, 70% tumor stage I) were analyzed. In total, 20% reported to eat healthier from diagnosis up to 18 months after initial treatment, 17% reported less physical activity and 20% more physical activity. Health awareness (OR 2.79, 95% CI: 1.38; 5.65), body change concerns (OR 3.04 95% CI: 1.71; 5.39), life interferences (OR 4.88 95% 2.29; 10.38) and worry (OR 2.62, 95% CI: 1.42; 4.85) were significantly associated with less physical activity up to 18 months after initial treatment whereby gastrointestinal symptoms were an important confounder. Conclusion(s) This study underlines the need to raise awareness of the benefits of a healthy lifestyle and to provide tailored lifestyle advice, taking into account survivors’ health awareness, body change concerns, life interferences, worry and gastrointestinal symptoms, in order to improve health behavior among gynecological cancer survivors. Trial Registration http://clinicaltrials.gov Identifier: NCT01185626, August 20, 2010

Purpose: Obesity is prevalent in gynecological cancer survivors and is associated with impaired health outcomes. Concerns due to cancer and its treatment may impact changes in lifestyle after cancer. This study aimed to assess the association between cancer-related psychosocial factors and changes in physical activity and diet, 18 months post-diagnosis among gynecological cancer survivors.Methods: Cross-sectional data from the ROGY care study were used, including endometrial and ovarian cancer patients treated with curative intent. The impact of cancer scale (IOCv2) was used to assess cancer-related psychosocial factors. Self-reported changes in nutrients/food groups and in physical activity post-diagnosis were classified into change groups (less/equal/more). Multivariable logistic regression models were used to assess associations.Results: Data from 229 cancer survivors (59% endometrial, 41% ovarian, mean age 66 ±9.5,70% tumor stage I) were analyzed. In total, 20% reported to eat healthier from diagnosis up to 18 months post-diagnosis, 17%reported less physical activity and 20% more physical activity. Health awareness, body change concerns, life interferences and worry were significantly associated with less physical activity up to 18 months post-diagnosis whereby gastrointestinal symptoms were an important confounder.Conclusion(s): This study underlines the need to raise awareness of the benefits of a healthylifestyle and to provide tailored lifestyle advice, taking into account survivors’ health awareness, body change concerns, life interferences, worry and gastrointestinalsymptoms, in order to improve health behavior among gynecological cancer survivors.Trial Registration: clinicaltrials.gov Identifier: NCT01185626, August 20, 2010