School of Interdisciplinary Health, College of Health Professions, Grand Valley State University, 500 Lafayette Ave NE, Grand Rapids, MI, 49503, USA.
Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Cancer Causes Control. 2023 Mar;34(3):277-286. doi: 10.1007/s10552-022-01663-x. Epub 2022 Dec 22.
Physical activity (PA) is associated with many health benefits. While PA has been associated with reduced mortality after breast cancer diagnosis in many studies, few studies have examined the role of PA in breast cancer survival among underserved and minority populations, including Black women. We investigated PA in association with mortality among Black predominantly low-income breast cancer survivors in the Southern Community Cohort Study (SCCS).
Study participants were women diagnosed with incident breast cancer (n = 949) in the SCCS, which is a prospective cohort study of predominantly low-income adults aged 40-79 years recruited from 12 Southeastern states between 2002 and 2009. Participants completed a detailed baseline questionnaire, with annual follow-up for mortality via registry linkages. Cox regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations of pre-diagnosis PA (measured via a validated questionnaire) with all-cause and breast cancer-specific mortality.
Breast cancer survivors had a mean age of 61.1 years and most (79.3%) had a household income of < $25,000. In adjusted models, higher levels of total PA (MET-hours/day) were inversely associated with all-cause mortality with HRs (95% CIs): 0.79 (0.59-1.06), 0.66 (0.49-0.90), and 0.60 (0.43-0.84), for Q2, Q3, and Q4 (reference: Q1), respectively, p ≤ 0.01. A similar inverse association was found for breast cancer-specific mortality.
Higher levels of pre-diagnosis PA were associated with improved survival among low-income Black breast cancer survivors. Resources to reduce barriers to PA participation and increase support for education and intervention efforts to promote PA among Black women are needed.
身体活动(PA)与许多健康益处相关。虽然许多研究表明 PA 与乳腺癌诊断后的死亡率降低有关,但很少有研究调查 PA 在包括黑人女性在内的服务不足和少数族裔人群中的乳腺癌生存中的作用。我们调查了在南方社区队列研究(SCCS)中,PA 与黑人低收入乳腺癌幸存者的死亡率之间的关系。
研究参与者为 SCCS 中诊断患有乳腺癌的女性(n=949),这是一项针对 2002 年至 2009 年间从 12 个东南州招募的年龄在 40-79 岁的以低收入为主的成年人的前瞻性队列研究。参与者完成了一份详细的基线问卷,并通过注册表链接进行年度随访以确定死亡率。使用 Cox 回归模型来估计与全因和乳腺癌特异性死亡率相关的诊断前 PA(通过验证问卷测量)的调整后的危险比(HR)和 95%置信区间(CI)。
乳腺癌幸存者的平均年龄为 61.1 岁,大多数(79.3%)的家庭收入低于$25,000。在调整模型中,较高水平的总 PA(MET-小时/天)与全因死亡率呈负相关,HR(95%CI)分别为:0.79(0.59-1.06)、0.66(0.49-0.90)和 0.60(0.43-0.84),分别对应 Q2、Q3 和 Q4(参考:Q1),p≤0.01。对于乳腺癌特异性死亡率也发现了类似的负相关关系。
较高水平的诊断前 PA 与低收入黑人乳腺癌幸存者的生存改善相关。需要资源来减少 PA 参与的障碍,并增加对教育和干预措施的支持,以促进黑人女性的 PA。