Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
J Cancer Surviv. 2023 Jun;17(3):848-858. doi: 10.1007/s11764-022-01264-2. Epub 2022 Nov 9.
There is a growing population of adolescent and young adult (AYA, ages 15-39 at diagnosis) cancer survivors at heightened risk of chronic conditions. Moderate to vigorous physical activity level (MVPA) is an important modifiable factor associated with improved cardiovascular health. Little is known about the association of sociodemographic factors with MVPA in AYA survivors.
Self-reported data from the National Health Interview Survey (2009-2018) were used to identify AYA cancer survivors (at least 2 years post-diagnosis) and age- and sex-matched controls. MVPA level based on sociodemographic (sex, race and ethnicity, income, education), medical (heart disease, stroke, and diabetes), and cardiovascular risk factors (BMI and smoking) was determined within and between survivors and controls using multivariable linear regression models.
A total of 4766 AYA cancer survivors and 47,660 controls were included. Less than half of survivors (41.9%) and controls (43.2%) met MVPA guideline recommendations, and one-third of survivors (33.4%) reported no MVPA. Black race was associated with reduced MVPA compared with White race (ratio: 0.58 (95% CI: 0.37-0.90). Household income < $50,000/year, education < high school, diagnoses of diabetes or heart disease, and current smoking were all significantly associated with reduced MVPA in AYA survivors. There were no differences in MVPA between survivors and controls by sociodemographic factors, medical history, and cardiovascular risk factors.
We found disparities in MVPA in AYA cancer survivors by sociodemographic, medical, and cardiovascular risk factors. Understanding trajectories of MVPA among different sociodemographic populations is needed to identify opportunities for intervention.
患有青少年和年轻成人癌症（诊断时年龄为 15-39 岁）的幸存者人数不断增加，他们处于慢性病高发的风险之中。中等到剧烈的身体活动水平（MVPA）是与改善心血管健康相关的重要可改变因素。关于社会人口因素与 AYA 幸存者 MVPA 的关联知之甚少。
使用 2009 年至 2018 年国家健康访谈调查（National Health Interview Survey）的自我报告数据，确定 AYA 癌症幸存者（至少在诊断后 2 年）和年龄及性别匹配的对照组。使用多变量线性回归模型，根据社会人口统计学（性别、种族和民族、收入、教育）、医学（心脏病、中风和糖尿病）和心血管危险因素（BMI 和吸烟），确定幸存者和对照组内部及之间的 MVPA 水平。
共纳入 4766 名 AYA 癌症幸存者和 47660 名对照组。不到一半的幸存者（41.9%）和对照组（43.2%）符合 MVPA 指南建议，三分之一的幸存者（33.4%）报告没有进行 MVPA。与白人相比，黑人种族的 MVPA 较低（比值：0.58（95%CI：0.37-0.90））。家庭收入<50,000 美元/年、教育程度<高中、患有糖尿病或心脏病、以及当前吸烟均与 AYA 幸存者 MVPA 减少显著相关。幸存者和对照组之间在社会人口统计学因素、病史和心血管危险因素方面的 MVPA 无差异。
我们发现 AYA 癌症幸存者的 MVPA 存在社会人口统计学、医学和心血管危险因素方面的差异。需要了解不同社会人口统计学人群中 MVPA 的轨迹，以确定干预机会。
