Race/Ethnicity, Physical Activity, and Quality of Life in Breast Cancer Survivors

Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, Bethesda, MD 20892-7344, USA.
Cancer Epidemiology Biomarkers & Prevention (Impact Factor: 4.13). 02/2009; 18(2):656-63. DOI: 10.1158/1055-9965.EPI-08-0352
Source: PubMed


To examine associations between recreational physical activity and quality of life (QOL) in a multiethnic cohort of breast cancer survivors, specifically testing whether associations are consistent across racial/ethnic groups after accounting for relevant medical and demographic factors that might explain disparities in QOL outcomes.
Data were collected from a population-based cohort of non-Hispanic White (n = 448), Black (n = 197), and Hispanic (n = 84) breast cancer survivors (stage 0-IIIa) in the Health, Eating, Activity, and Lifestyle Study. Physical activity was assessed approximately 2.5 years after breast cancer diagnosis, with QOL assessed on average 6 to 12 months later. We used structural equation modeling to examine relationships between meeting recommended levels of physical activity and QOL, stratifying by race/ethnicity and adjusting for other demographic, comorbidity, and treatment effects.
Structural equation modeling indicated that meeting recommended levels of physical activity had significant positive associations with QOL for Black and non-Hispanic White women (P < 0.05). Fewer Black women reported meeting recommended physical activity levels (P < 0.001), but meeting recommendations was associated with better QOL. Post hoc tests showed that meeting physical activity recommendations was specifically associated with better vitality, social functioning, emotional roles, and global QOL (P < 0.05 for all).
These results suggest that meeting recommended levels of physical activity is associated with better QOL in non-Hispanic White and Black breast cancer survivors. Findings may help support future interventions among breast cancer survivors and promote supportive care that includes physical activity, although more research is needed to determine these relationships among Hispanic and other ethnic minority women.

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    • "Furthermore, among short-term breast cancer survivors, obesity among blacks is similar to whites, but is increased compared to whites among long-term survivors. These differences in obesity and comorbidities may explain the lower quality life and poor survival following a breast cancer diagnosis observed among blacks compared to whites [12, 14, 33]. Additional research is needed to identify when to and who should counsel breast cancer survivors who may not be practicing healthy habits. "
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    ABSTRACT: Purpose Differences in health status and behavioral risk factors may explain racial/ethnic breast cancer disparities. We examined racial/ethnic differences in health status and behaviors among female breast cancer survivors compared to females without breast cancer. Methods Using cross-sectional data from the 2009 Behavioral Risk Factor Surveillance System, a national state-based, random sample telephone survey, we explored differences in self-rated health, obesity and selected behaviors (physical activity, smoking, alcohol use, fruit, and vegetable consumption) among females aged 18 years and older, who reported a previous breast cancer diagnosis (survivors, n = 10,035) and those who reported no breast cancer history (n = 234,375) by race/ethnicity. Adjusted prevalences of health status and behaviors, accounting for sociodemographics, comorbidities and health care access, were estimated by race/ethnicity. Results Compared to all other racial/ethnic groups, more white females reported heavy alcohol consumption and more black females reported obesity regardless of their breast cancer status. Among breast cancer survivors, more whites (33.7 %) were former smokers compared to blacks (24.5 %), “others” (20.5 %), and Hispanics (16.2 %) (p = 0.001). Racial/ethnic differences in obesity also varied by reported time since diagnosis (p value = 0.018). Among long-term survivors (diagnosed >5 years before interview), more black survivors (34.8 %) reported obesity compared to white survivors (23.0 %). Also, among “other” race survivors, long-term survivors (22.0 %) reported more obesity than survivors diagnosed less than 5 years before interview (7.8 %). Conclusions These findings suggest opportunities to increase health behaviors and reduce racial disparities among breast cancer survivors. Implications for Cancer Survivors Engaging in healthy behaviors can play a significant role in enhancing health outcomes and quality of life of breast cancer survivors. More research is needed to better understand racial differences in obesity, smoking and alcohol consumption in order to develop effective, culturally appropriate interventions to promote a healthy lifestyle after a breast cancer diagnosis.
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