Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine/NewYork-Presbyterian, 420 East 70th Street, Box 331, New York, NY, 10021, USA.
Division of Population Health Science, Weill Cornell Medicine/NewYork-Presbyterian, New York, NY, USA.
Cancer Causes Control. 2022 May;33(5):759-768. doi: 10.1007/s10552-022-01560-3. Epub 2022 Mar 11.
Despite cancer and cardiovascular disease (CVD) sharing several modifiable risk factors, few unified prevention efforts exist. We sought to determine the association between risk perception for cancer and CVD and engagement in healthy behaviors.
Between May 2019 and August 2020, we conducted a cross-sectional survey of adults ≥ 40 years residing in Brooklyn neighborhoods with high cancer mortality. We considered one's perceived risk of cancer and CVD compared to age counterparts as the primary exposures. The primary study outcome was a weighted health behavior score (wHBS) composed of 5 domains: physical activity, no obesity, no smoking, low alcohol intake, and healthy diet. Modified Poisson regression models with robust error variance were used to assess associations between perceived risk for cancer and CVD and the wHBS, separately.
We surveyed 2448 adults (mean [SD] age, 61.4 [12.9] years); 61% female, 30% Non-Hispanic White, and 70% racial/ethnic minorities. Compared to their age counterparts nearly one-third of participants perceived themselves to be at higher CVD or cancer risk. Perceiving higher CVD risk was associated with an 8% lower likelihood of engaging in healthy behaviors (RR 0.92; 95% CI 0.86-0.99). Perceiving greater cancer risk was associated with a 14% lower likelihood of engaging in healthy behaviors (RR 0.86; 95% CI 0.79-0.95). The association between cancer risk and wHBS attenuated but remained significant (aRR 0.90; 95% CI 0.82-0.98) after adjustment.
Identifying high-risk subgroups and intervening on shared risk behaviors could have the greatest long-term impact on reducing CVD and cancer morbidity and mortality.
尽管癌症和心血管疾病（CVD）有一些可改变的危险因素，但很少有统一的预防措施。我们旨在确定癌症和 CVD 风险感知与健康行为参与之间的关联。
2019 年 5 月至 2020 年 8 月，我们对居住在布鲁克林高癌症死亡率社区的≥40 岁成年人进行了一项横断面调查。我们将一个人对癌症和 CVD 的感知风险与同龄人的风险进行比较，作为主要暴露因素。主要研究结果是由 5 个领域组成的加权健康行为评分（wHBS）：身体活动、不肥胖、不吸烟、低酒精摄入和健康饮食。采用具有稳健误差方差的修正泊松回归模型分别评估癌症和 CVD 风险感知与 wHBS 之间的关联。
我们调查了 2448 名成年人（平均[SD]年龄为 61.4[12.9]岁）；61%为女性，30%为非西班牙裔白人，70%为种族/民族少数群体。与他们的年龄相仿者相比，近三分之一的参与者认为自己有更高的 CVD 或癌症风险。感知到更高的 CVD 风险与更不可能参与健康行为的 8%相关（RR 0.92；95%CI 0.86-0.99）。感知到更高的癌症风险与更不可能参与健康行为的 14%相关（RR 0.86；95%CI 0.79-0.95）。在调整后，癌症风险与 wHBS 的关联减弱，但仍有统计学意义（aRR 0.90；95%CI 0.82-0.98）。
确定高风险亚组并对共同的风险行为进行干预，可能对降低 CVD 和癌症发病率和死亡率产生最大的长期影响。
