Gender differences in the lifestyle of cancer patients assessed using the HEALTH Onco questionnaire

Background. Lifestyle factors — including diet, physical activity, sleep quality, stress management, and patient–physician communication — are increasingly recognized as modifiable determinants of cancer progression and survival. However, clinical practice lacks a brief, holistic instrument to simultaneously assess patients' awareness of these factors and their actual behavioral engagement. We developed the "HEALTH-Onco" questionnaire and piloted it to evaluate gender differences in lifestyle patterns among cancer patients. Methods. A cross-sectional pilot study was conducted using the "HEALTH-Onco" questionnaire, which comprises five blocks: awareness of lifestyle–cancer links (Block 1), behavioral practices including nutrition and physical activity (Block 2), perceived barriers (Block 3), patient–physician communication (Block 4), and motivation/belief in recovery (Block 5). A Food Utility Index (FUI) was calculated as a weighted average of selected dietary components. A total Healthy Lifestyle Adherence Index (HLAI) was computed as the sum of all block scores. The questionnaire was administered to 45 cancer patients (23 women, 22 men) at various treatment stages. Gender differences were analyzed across all blocks. Results. Correlation analysis revealed that a positive attitude and optimism were associated with lower dietary caloric intake and more frequent morning exercise, whereas pessimistic patients tended to overeat as a coping response to stress. The physician's influence on the patient's mindset and lifestyle choices was found to be decisive: patients who trusted their doctor were substantially more willing to modify their dietary and behavioral habits. Gender-specific differences in individual lifestyle domains were also identified and are discussed. Conclusions. The "HEALTH-Onco" questionnaire is a feasible, multidimensional tool for assessing lifestyle-related awareness and behavior in cancer patients. Psychological disposition and physician–patient trust emerge as key drivers of adherence to healthy lifestyle behaviors. Further validation in a larger, multicenter cohort is warranted.