北加利福尼亚女性乳腺癌幸存者合并队列中的出生情况与健康生活方式指数

Nativity and Healthy Lifestyle Index in a Pooled Cohort of Female Breast Cancer Survivors from Northern California.

作者信息

Aoki Rhonda-Lee, Alexeeff Stacey E, Caan Bette J, Kushi Lawrence H, Gomez Scarlett Lin, Torres Jacqueline M, Canchola Alison J, Morey Brittany N, Kroenke Candyce H

机构信息

Division of Research, Kaiser Permanente Northern California, Pleasanton, California.

Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California.

出版信息

Cancer Epidemiol Biomarkers Prev. 2025 Jul 1;34(7):1188-1198. doi: 10.1158/1055-9965.EPI-24-1871.

DOI:10.1158/1055-9965.EPI-24-1871

PMID:40333068

Abstract

BACKGROUND

In the United States, breast cancer is common in Asian, Hispanic, and non-Hispanic White (NHW) women, many of whom are immigrants. A healthy lifestyle is vital to survival, but it is unknown how lifestyle varies by nativity among survivors.

METHODS

The study included 4,754 racially diverse, female breast cancer survivors from the Northern California, Exploring Networks in a Cohort of Latina and Asian Emigrants, Lifestyle, and Vital Status (ENCLAVE) study. We generated a healthy lifestyle index (HLI) based on World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations. Log-binomial regression models, controlling for sociodemographics, were used to evaluate associations between nativity and the highest tertile of HLI, as well as the optimal category of each HLI component.

RESULTS

Foreign-born (vs. US-born) women were more likely to have a high HLI [prevalence ratio (PR) = 1.44; 95% confidence interval (CI), 1.31-1.59]. In stratified models, we observed stronger associations among Hispanic (PR = 1.76; 95% CI, 1.39-2.24) and Asian (PR = 1.60; 95% CI, 1.32-1.94) versus non-Hispanic White (PR = 1.26; 95% CI, 1.08-1.47) women (P-interaction = 0.02). Foreign-born (vs. US-born) women were more likely to have a waist circumference <31.5 inches (PR = 1.19; 95% CI, 1.03-1.37); be normal weight (PR = 1.23; 95% CI, 1.11-1.37); never smoke (PR = 1.11; 95% CI, 1.06-1.17); and consume no sweets (PR = 1.44; 95% CI, 1.21-1.70), low red meat (PR = 1.46; 95% CI, 1.33-1.60), and high fruits and vegetables (PR = 1.46; 95% CI, 1.32-1.62).

CONCLUSIONS

Among women diagnosed with breast cancer, foreign-born women had a healthier lifestyle than US-born women.

IMPACT

Lifestyle differences by nativity in breast cancer survivors may help clarify prognostic differences by nativity.

摘要

背景

在美国，乳腺癌在亚裔、西班牙裔和非西班牙裔白人（NHW）女性中很常见，其中许多是移民。健康的生活方式对生存至关重要，但尚不清楚幸存者的生活方式因出生地而异的情况。

方法

该研究纳入了来自北加利福尼亚的4754名种族多样的女性乳腺癌幸存者，即拉丁裔和亚裔移民、生活方式与生命状况队列探索网络（ENCLAVE）研究。我们根据世界癌症研究基金会/美国癌症研究学会的癌症预防建议生成了一个健康生活方式指数（HLI）。使用控制社会人口统计学因素的对数二项回归模型来评估出生地与HLI最高三分位数之间的关联，以及每个HLI组成部分的最佳类别之间的关联。

结果

外国出生（与美国出生相比）的女性更有可能拥有较高的HLI[患病率比值（PR）=1.44；95%置信区间（CI），1.31 - 1.59]。在分层模型中，我们观察到西班牙裔（PR = 1.76；95% CI，1.39 - 2.24）和亚裔（PR = 1.60；95% CI，1.32 - 1.94）女性与非西班牙裔白人女性（PR = 1.26；95% CI，1.08 - 1.47）相比有更强的关联（P交互作用 = 0.02）。外国出生（与美国出生相比）的女性更有可能腰围<31.5英寸（PR = 1.19；95% CI，1.03 - 1.37）；体重正常（PR = 1.23；95% CI，1.11 - 1.37）；从不吸烟（PR = 1.11；95% CI，1.06 - 1.17）；并且不吃甜食（PR = 1.44；95% CI，1.21 - 1.70）、少吃红肉（PR = 1.46；95% CI，1.33 - 1.60）以及多吃水果和蔬菜（PR = 1.46；95% CI，1.32 - 1.62）。