Ho Katherine L, Tu Yanxin, Dibble Kate E, Visvanathan Kala, Connor Avonne E
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Office E-6144, Baltimore, MD, 21205, USA.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Breast Cancer Res Treat. 2025 Jan;209(2):253-259. doi: 10.1007/s10549-024-07543-z. Epub 2024 Nov 10.
Weight management is included in the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guidelines for its clinical impact on breast cancer (BC) survivorship. Few studies have examined the impact of neighborhood-level factors associated with postdiagnosis weight change among Black BC survivors.
We recruited 100 Black female BC survivors to complete an online survey, including demographic, clinical characteristics, and lifestyle factors, between January 5, 2022 and August 18, 2022. We utilized the 2023 County Health Rankings Food Environment Index (FEI), which ranges from 0 (worst) to 10 (best), to capture the food environment as the primary exposure for postdiagnosis weight gain. We calculated postdiagnosis weight gain as percent weight change from time at diagnosis to time of survey. Participants were grouped into categories of stable weight (within ± 3%) or weight loss (≤ -3%) compared to weight gain (≥ 3%). We calculated adjusted odds ratios (aORs) for the associations between county-FEI, clinical factors, and postdiagnosis weight gain.
Among the 95 women who reported weight measurements, we observed that women living in counties with an FEI ≥ 8.8 (at or above median) were significantly less likely to experience weight gain (aOR 0.09; 95% CI 0.01-0.77). Stage, age at diagnosis, years since BC diagnosis, and BC treatments were not significantly associated with weight gain.
Postdiagnosis weight gain is associated with poorer food environments among Black BC survivors in Maryland. Our findings will inform larger prospective studies and future interventions among this population.
体重管理因其对乳腺癌（BC）幸存者的临床影响而被纳入美国癌症协会/美国临床肿瘤学会乳腺癌幸存者护理指南。很少有研究探讨与黑人BC幸存者诊断后体重变化相关的邻里层面因素的影响。
我们招募了100名黑人女性BC幸存者，在2022年1月5日至2022年8月18日期间完成一项在线调查，包括人口统计学、临床特征和生活方式因素。我们使用2023年县健康排名食品环境指数（FEI），范围从0（最差）到10（最佳），以获取食品环境作为诊断后体重增加的主要暴露因素。我们将诊断后体重增加计算为从诊断时间到调查时间的体重变化百分比。与体重增加（≥3%）相比，参与者被分为体重稳定（±3%以内）或体重减轻（≤-3%）类别。我们计算了县FEI、临床因素与诊断后体重增加之间关联的调整比值比（aOR）。
在报告体重测量的95名女性中，我们观察到生活在FEI≥8.8（中位数及以上）县的女性体重增加的可能性显著降低（aOR 0.09；95%CI 0.01-0.77）。分期、诊断时年龄、BC诊断后的年数和BC治疗与体重增加无显著关联。
马里兰州黑人BC幸存者诊断后体重增加与较差的食品环境有关。我们的研究结果将为该人群中更大规模的前瞻性研究和未来干预提供信息。
