Fitness, Body Composition, and Health Behaviors in Long-Term Survivors of Adolescent and Young Adult Cancers

<b><i>Purpose:</i></b> To investigate cardiorespiratory fitness (CRF), body composition, health behaviors, and health-related quality of life (HRQoL) in adolescent and young adult cancer survivors (AYA-CS) compared with age-matched counterparts without a cancer diagnosis. <b><i>Methods:</i></b> This cross-sectional study recruited participants aged 15-25 years at the time of their cancer diagnosis and ≥ 5 years post-treatment. Participants completed cardiopulmonary exercise testing, dual-energy X-ray absorptiometry, food diaries, physical activity (PA), fatigue, and HRQoL questionnaires. <b><i>Results:</i></b> We recruited 22 participants aged 27.9 (standard deviation [SD] 3.3) years (54.5% female) and 7.2 (SD 2.2) years post-treatment. AYA-CS had lower CRF compared with age-matched norms (female 27.1 vs. 39.1 mL/kg/min, <i>p</i> ≤ 0.0001; male: 39.7 vs. 45.6 mL/kg/min, <i>p</i> = 0.04). Bone mineral density <i>Z</i>-scores were all within normal ranges; however, male AYA-CS had higher body fat percentage (male: 27.1% vs. 21.2%, <i>p</i> = 0.01) and a trend toward higher body fat percentage in female AYA-CS (32.2% vs. 29.8%, <i>p</i> = 03). AYA-CS had lower HRQoL, with no difference observed with fatigue. A higher proportion of AYA-CS met recommendations for weekly PA (36.4% vs. 27.3%, <i>p</i> = 0.34) and daily servings of fruit and vegetables (13.6% vs. 3.9%, <i>p</i> = 0.02) compared with normative data, demonstrating better health behaviors. A higher proportion of AYA-CS reported one or more chronic diseases compared with Australian normative data (63.7% vs. 41.5%, <i>p</i> = 0.04). <b><i>Conclusions:</i></b> AYA-CS exhibit significantly lower CRF and unfavorable body composition to age-matched counterparts. These health outcomes may adversely impact everyday functional performance and increase the risk of multimorbidity development. Interventions are needed to address these issues to improve health outcomes in AYA-CS.