Abstract 5937: Are female cancer survivors meeting exercise recommendations for cancer survivorship: Evaluation of disparities by race/ethnicity and US nativity
Authors: Dibble Kate E. , Connor Avonne E. 
Published: June 2022

Abstract
Purpose: We examined disparities among female cancer survivors in associations between race/ethnicity, United Statues (US) nativity, and odds of meeting the American College of Sports Medicine (ACSM) weekly exercise recommendations for adult cancer survivors, determining if different by comorbidity and obesity status.
Methods: We analyzed 2,044 adult females with a history of cancer 2+ years since initial cancer diagnosis from the National Health and Nutrition Examination Survey (NHANES 1999-2018). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression for associations between race/ethnicity (non-Hispanic white [NHW], non-Hispanic Black [NHB], Hispanic/Mexican American, additional racial/ethnic groups), US nativity (US-born, foreign-born), and time of acculturation (US-born, foreign-born &lt;15 years in US, foreign-born ≥15 years in US) and odds of meeting weekly exercise recommendations accounting for examination weights and covariates. Statistical interactions between stratifications (comorbidity status [none, at least one]; BMI [underweight/normal, overweight/obese]) were conducted.
Results: Most were breast cancer survivors (33.8%), NHW (64.1%), born in the US (84.5%), overweight/obese (69.9%), and did not meet recommendations (66.5%). NHB survivors were significantly less likely to meet recommendations (aOR, 0.66, 95% CI, 0.47-0.92) than NHW survivors. Foreign-born women were 3.41 times more likely to meet recommendations (95% CI, 1.18-9.85) compared to US-born women. Survivors who were foreign-born and lived in the US for ≥15 years were significantly less likely to meet recommendations (aOR, 0.43, 95% CI, 0.21-0.87) compared to US natives. Comorbidity status significantly modified (p-interaction&lt; 0.05) the associations between US nativity and time of acculturation and BMI modified the relationship between race/ethnicity and odds of meeting recommendations (p-interaction=0.013). NHB survivors who were underweight/normal weight were 2 times more likely (95% CI, 0.96-4.77) to meet recommendations while overweight/obese NHB survivors were significantly less likely (aOR, 0.27; 95% CI 0.13-0.56).
Conclusion: Our study results confirm that racial/ethnic disparities exist in meeting exercise recommendations among NHB survivors, particularly those overweight/obese. Our findings provide new evidence for disparities in meeting exercise recommendations among female cancer survivors born outside of the US. While foreign-born survivors were more likely to meet recommendations, living in the US for 15+ years was significantly associated with reduced odds of meeting recommendations. Results can inform researchers and clinicians to better tailor lifestyle and exercise interventions for these women to identify barriers for improving adherence.
Citation Format: Kate E. Dibble, Avonne E. Connor. Are female cancer survivors meeting exercise recommendations for cancer survivorship: Evaluation of disparities by race/ethnicity and US nativity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5937.