Nayak Pratibha, Paxton Raheem J, Holmes Holly, Thanh Nguyen Hoang, Elting Linda S
Department of General Internal Medicine, University of Texas MD Anderson Cancer Center; Health Promotion and Behavioral Sciences, University of Texas Health Science Center, Houston.
Department of Behavioral and Community Health, University of North Texas Health Science Center, Fort Worth, Texas.
Am J Prev Med. 2015 Jun;48(6):729-36. doi: 10.1016/j.amepre.2014.12.015.
Previous studies of health behaviors of adult cancer survivors have not adequately examined racial and ethnic differences because of small sample sizes. A national data set was used to examine differences in health behaviors between cancer survivors and controls and between racial and ethnic groups among survivors.
The study analyzed 2009 Behavioral Risk Factor Surveillance System survey data in 2012-2014. Descriptive statistics were used to examine differences in health behaviors between cancer survivors and controls aged 20-64 years. Multivariable analysis was conducted to examine associations between race/ethnicity (white, African American, Hispanic, Asian, or Native American) and health behaviors (BMI, fruit and vegetable consumption, physical activity, and smoking status) while adjusting for demographic and medical characteristics. Significance was set at p<0.01.
Compared with controls (n=245,283), cancer survivors (n=17,158) had higher prevalence rates for overweight/obese status (67% vs 65%); not meeting physical activity recommendations (53% vs 49%); and current smoking status (22% vs 20%). In the multivariable model, diet and smoking behavior differed across cancer status. African American (AOR=1.95) and Hispanic (AOR=2.06) survivors were more likely to have higher BMI than white survivors. African American survivors (AOR=1.6) were less likely to meet physical activity guidelines. Native American (AOR=3.08) and multiracial (AOR=1.74) survivors were more likely to be current smokers than non-Hispanic white survivors.
This study suggests that racial and ethnic differences exist in the adoption of recommended health behaviors; future research should identify factors to reduce these differences.
以往关于成年癌症幸存者健康行为的研究由于样本量较小，未能充分考察种族和民族差异。本研究使用全国性数据集，以检验癌症幸存者与对照组之间以及幸存者中不同种族和民族群体之间的健康行为差异。
本研究分析了2012 - 2014年的2009年行为危险因素监测系统调查数据。采用描述性统计方法来检验20 - 64岁癌症幸存者与对照组之间的健康行为差异。进行多变量分析，以检验种族/民族（白人、非裔美国人、西班牙裔、亚裔或美国原住民）与健康行为（体重指数、水果和蔬菜摄入量、身体活动及吸烟状况）之间的关联，同时对人口统计学和医学特征进行调整。显著性水平设定为p<0.01。
与对照组（n = 245,283）相比，癌症幸存者（n = 17,158）超重/肥胖状态的患病率更高（67%对65%）；未达到身体活动建议标准的比例更高（53%对49%）；当前吸烟率更高（22%对20%）。在多变量模型中，饮食和吸烟行为因癌症状态而异。非裔美国人（调整后比值比[AOR]=1.95）和西班牙裔（AOR = 2.06）幸存者比白人幸存者更有可能具有较高的体重指数。非裔美国人幸存者（AOR = 1.6）达到身体活动指南标准的可能性较小。美国原住民（AOR = 3.08）和多种族（AOR = 1.74）幸存者比非西班牙裔白人幸存者更有可能当前仍在吸烟。
本研究表明在采取推荐的健康行为方面存在种族和民族差异；未来的研究应确定减少这些差异的因素。
