Transitions out of high school: time of increased cancer risk?

BACKGROUND The effectiveness of lifestyle behavior interventions with children to reduce chronic disease risks in adulthood assumes stability in the lifestyle behaviors across time. The transition out of high school is a time when many changes occur in social roles, e.g., changing schools, leaving the parents' home, changing peers, finding employment, getting married, and becoming a parent. Cancer risk behaviors may increase as a result of some of these social role changes. METHODS Concepts relevant to the stability or change in lifestyle behaviors through the transition out of high school are presented. Literature concerning diet, smoking, smokeless tobacco, alcohol, physical activity, sexual practices, and sun exposure behaviors through the transition is reviewed. RESULTS Most lifestyle behaviors display increasing cancer risk around the transition out of high school. Different levels of change were associated with different pathways through the transition. Inconsistent findings were obtained in the pattern of co-occurrence of these behaviors. CONCLUSION Priority research includes establishing the pattern of co-occurrence of lifestyle behaviors through the transition, identifying the pattern of tracking of each behavior through the transition, and identifying the primary influences on the group values and tracking of the behaviors. Longitudinal research is needed to control for preexisting differences between pathways through the transition.