Adherence to Lifestyle Recommendations and Role of Information Sources in Cancer Follow-up: A Cross Sectional Study

Adherence to lifestyle recommendations among cancer survivors is essential for reducing the risk of recurrence and improving quality of life, but remains suboptimal. The role of information sources in improving patient knowledge and behavior is a key component of cancer education. This study aims to evaluate adherence to international dietary and lifestyle recommendations in cancer survivors during follow-up and to assess the impact of information sources on knowledge and self-reported behavioral change. A cross-sectional study was conducted in 500 adult cancer survivors attending follow-up visits at a Medical Oncology Unit of Syracuse. An anonymous questionnaire assessed dietary habits, physical activity, smoking and alcohol use, knowledge of international recommendations, and source of information. An adherence score classified patients into four categories (critical, low, moderate, high). Descriptive and comparative analyses examined associations between information sources, knowledge, and behavioral change. Low adherence to dietary and lifestyle recommendations was observed in 52% of patients, while accurate knowledge of lifestyle recommendations was reported by 23% of participants. Similarly, 66% reported no dietary changes and 56% were physically inactive. Patients informed by healthcare professional sources showed higher levels of knowledge and greater likelihood of adopting healthy behaviors than those who relied on informal sources. Adherence to lifestyle recommendations in cancer survivorship is limited and influenced by the source and quality of information. Integrating structured, multidisciplinary cancer education and lifestyle counseling into routine follow-up may improve knowledge, risk perception, and long-term behavioral outcomes.