Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Atlanta, GA 30341, USA.
J Cancer Surviv. 2013 Mar;7(1):93-103. doi: 10.1007/s11764-012-0248-4. Epub 2012 Dec 5.
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.
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.
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 %).
These findings suggest opportunities to increase health behaviors and reduce racial disparities among breast 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.
健康状况和行为风险因素的差异可能导致不同种族/族裔间乳腺癌发病存在差异。本研究旨在比较女性乳腺癌幸存者与无乳腺癌女性的健康状况和行为差异。
本研究使用 2009 年行为风险因素监测系统（BRFSS）的横断面数据，该系统是一项全国性、基于州的随机电话调查。我们调查了报告有乳腺癌既往史的女性（幸存者，n=10035）和报告无乳腺癌史的女性（n=234375）的自感健康状况、肥胖以及某些行为（体力活动、吸烟、饮酒、水果和蔬菜摄入）的差异，这些女性年龄均在 18 岁及以上。按照种族/族裔，调整了社会人口统计学、合并症和医疗保健获取情况后，对健康状况和行为的调整后流行率进行了估计。
与其他所有种族/族裔群体相比，更多的白人女性报告饮酒量较大，更多的黑人女性报告肥胖，无论其乳腺癌状况如何。在乳腺癌幸存者中，与黑人（24.5%）、“其他”（20.5%）和西班牙裔（16.2%）相比，更多的白人（33.7%）曾为吸烟者（p=0.001）。肥胖的种族/族裔差异也因报告的诊断后时间而异（p 值=0.018）。在长期幸存者（诊断后>5 年）中，与白人幸存者（23.0%）相比，更多的黑人幸存者（34.8%）报告肥胖。此外，在“其他”种族幸存者中，长期幸存者（22.0%）报告肥胖的比例高于诊断时间不到 5 年前的幸存者（7.8%）。
这些发现表明有机会改善乳腺癌幸存者的健康行为，减少种族差异。
健康行为的养成对提高乳腺癌幸存者的健康结果和生活质量具有重要作用。需要进一步研究以更好地了解肥胖、吸烟和饮酒方面的种族差异，以便制定有效的、文化上适当的干预措施，促进乳腺癌诊断后的健康生活方式。
