Racial differences in physical activity among breast cancer survivors: Implications for breast cancer care

Hair, Brionna Y.; Hayes, Sandra C.; Tse, Chiu Kit; Bell, Mary B.; Olshan, Andrew F.

doi:10.1002/cncr.28630

Cited by 94 publications

(81 citation statements)

References 32 publications

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“…Similar to the rest of the US population, breast cancer patients bear substantial comorbidity burdens, particularly as they age, with rates of severe comorbidities rising to over 30 % among women age 65 and older (Edwards et al 2013 ;Cho et al 2013 ). Rising rates of breast cancer risk factors, such as obesity, metabolic syndrome, and reduced levels of physical activity may further contribute to high rates of comorbidity in breast cancer patients (Guh et al 2009 ;Berrino et al 2014 ;Hair et al 2014 ). Improvements in breast cancer survival in recent decades, however, have primarily been experienced among cancer patients without comorbidities, and less so among those with moderate or severe comorbidities (Cronin-Fenton et al 2007 ;Land et al 2012a ).…”

Section: Introductionmentioning

confidence: 97%

Comorbidities and Their Management: Potential Impact on Breast Cancer Outcomes

Hong

Ambrosone

Goodwin

2015

Advances in Experimental Medicine and Biology

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Pre-existing comorbidities negatively impacts overall breast cancer prognosis, increasing both breast cancer specific deaths as well as death from competing causes. Improvements in breast cancer survival in recent decades, however, have primarily been experienced among cancer patients without comorbidities, and less so among those with moderate or severe comorbidities. As guidelines for the treatment of breast cancer are mostly based on studies excluding patients with moderate and severe comorbidities with under-representation of older women with comorbid conditions, information regarding treatment effectiveness in breast cancer patients with comorbidities is currently lacking. This chapter describes the impact of comorbidities on breast cancer treatment and outcomes, previous research approaches taken, and specific populations that may be most susceptible to the effects of comorbidities on breast cancer outcomes. Future research directions are suggested that may help to improve understanding of comorbidity-related factors that underlie disparities in breast cancer outcomes, and to examine the potential role of effective management of comorbidities among breast cancer patients as a strategy to help close gaps in disease prognosis.

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Section: Introductionmentioning

confidence: 97%

Comorbidities and Their Management: Potential Impact on Breast Cancer Outcomes

Hong

Ambrosone

Goodwin

2015

Advances in Experimental Medicine and Biology

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“…Though limited, data from these reports suggest that they may be more likely to gain weight after diagnosis [14] and during treatment [15], and are less likely to meet physical activity or nutrition recommendations [16–19]. In a recent review of 82 physical activity trials, Speck and colleagues (2010) [20] concluded that 76% of reviewed studies did not properly describe the sample characteristics and race was the factor most commonly overlooked.…”

Section: Introductionmentioning

confidence: 99%

The feasibility and acceptability of a diet and exercise trial in overweight and obese black breast cancer survivors: The Stepping STONE study

Sheppard

Hicks

Makambi

et al. 2016

Contemporary Clinical Trials

104

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Purpose Black breast cancer survivors have high rates of obesity and low physical activity levels. Little is known about the acceptability and feasibility of interventions in this population. Objective A two-arm RCT was launched to assess the efficacy of a culturally targeted 12-week multimodal lifestyle intervention in overweight and obese black survivors. Methods Intervention components included nutrition education, exercise groups, and survivor-led motivational interviewing phone sessions. The analytic sample included women who completed the trial (intervention n = 10; control n = 12). Anthropometric measures, physical activity, and VO2max were assessed at baseline and follow-up. Change scores (intervention vs. control) were assessed with Wilcoxon rank-sum tests. A process evaluation assessed intervention acceptability. Results Overall adherence was 70% and overall satisfaction was high (86%). Despite the 5% weight loss target, the intervention group lost 0.8% but BMI improved. Total physical activity levels increased in the intervention vs. control arm (+3501 MET min/week vs. +965 MET min/week, respectively). VO2max improved in the intervention group (+0.10 ± 1.03 kg/L/min). Intervention participants reduced energy intake (−207.3 ± 31.5 kcals) and showed improvements in fat intake (−15.5 ± 3.8 g), fiber (+3.2 ± 1.2 g) and % energy from fat (−4.8 ± 3.1%). Survivors suggested providing diet/exercise information within a cancer context. Conclusions Group and individualized intervention strategies are acceptable to black survivors. Observed differences between self-report and objective outcomes may suggest reporting bias or changes in body composition. Increasing supervised intervention components and assessment of body composition will be important for future trials.

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“…In contrast, most studies evaluating post-diagnosis pa in cancer patients have involved survivors of breast and colorectal cancers. Those studies suggested that ethnicity 21 , social support 22,23 , and cancer-related beliefs 24 were influential factors.…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic Status and Lifestyle Behaviours in Cancer Survivors: Smoking and Physical Activity

et al. 2016

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Purpose Smoking cessation and increased physical activity (pa) have been linked to better outcomes in cancer survivors. We assessed whether socioeconomic factors influence changes in those behaviours after a cancer diagnosis. MethodsAs part of a cross-sectional study, a diverse group of cancer survivors at the Princess Margaret Cancer Centre (Toronto, ON), completed a questionnaire about past and current lifestyle behaviours and perceptions about the importance of those behaviours with respect to their health. The influence of socioeconomic indicators on smoking status and physical inactivity at 1 year before and after diagnosis were assessed using multivariable logistic regression with adjustment for clinico-demographic factors. ResultsOf 1222 participants, 1192 completed the smoking component. Of those respondents, 15% smoked before diagnosis, and 43% of those smokers continued to smoke after. The proportion of survivors who continued to smoke increased with lower education level (p = 0.03). Of the 1106 participants answering pa questions, 39% reported being physically inactive before diagnosis, of whom 82% remained inactive afterward. Survivors with a lower education level were most likely to remain inactive after diagnosis (p = 0.003). Lower education level, household income, and occupation were associated with the perception that pa had no effect or could worsen fatigue and quality of life (p ≤ 0.0001).Conclusions In cancer survivors, education level was a major modifier of smoking and pa behaviours. Lower socioeconomic status was associated with incorrect perceptions about pa. Targeting at-risk survivors by education level should be evaluated as a strategy in cancer survivorship programs.

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Racial differences in physical activity among breast cancer survivors: Implications for breast cancer care

Cited by 94 publications

References 32 publications

Comorbidities and Their Management: Potential Impact on Breast Cancer Outcomes

Comorbidities and Their Management: Potential Impact on Breast Cancer Outcomes

The feasibility and acceptability of a diet and exercise trial in overweight and obese black breast cancer survivors: The Stepping STONE study

Socioeconomic Status and Lifestyle Behaviours in Cancer Survivors: Smoking and Physical Activity

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