Abstract LB554: Multimorbidity and healthy lifestyle behaviors among US-based female cancer survivors
Authors: Connor Avonne E. , Dibble Kate E. 
Published: June 2022

Abstract
Purpose: The current study examined the associations between multimorbidity and odds of maintaining healthy lifestyle behaviors (meeting the American College of Sports Medicine weekly physical activity (PA) recommendations for adults, daily alcohol consumption, and smoking history) among adult female cancer survivors and examined differences by age at cancer diagnosis and race/ethnicity.
Methods: 2,005 adult females with a history of cancer two or more years since initial cancer diagnosis from the National Health and Nutrition Examination Survey (1999-2018) were included. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression for the associations between multimorbidity (≥2 comorbid conditions) and health behaviors, accounting for survey examination weights and covariates. Models were stratified by age at diagnosis and race/ethnicity and statistical interactions were examined to evaluate effect modification.
Results: Overall, female cancer survivors with multimorbidity were more likely to be ever smokers (aOR, 1.42; 95% CI 1.08-1.85) and were significantly less likely to drink ≥2 alcoholic drinks/day (aOR, 0.67; 95% CI 0.50-0.91) in comparison to female survivors without multimorbidity. This association with alcohol was significantly modified by race/ethnicity (non-Hispanic white (NHW) survivors: aOR, 0.61; 95% CI 0.44-0.86; minority survivors aOR, 1.09; 95% CI 0.67-1.79; p-interaction=0.04) and age at diagnosis (≥50 years of age at diagnosis: aOR, 0.44; 95% CI 0.28-0.69; &lt;50 years at diagnosis: aOR, 0.88; 95% 0.59-1.31; p-interaction=0.03). Overall, the association between multimorbidity and PA was not statistically significant. However, by race/ethnicity, minority cancer survivors with multimorbidity were two times more likely to meet weekly PA recommendations (aOR, 2.10; 95% CI 1.29-3.41), in comparison with minority survivors without multimorbidity; and there was no association observed among NHW survivors (p-interaction=0.005). By age at diagnosis, women ≥50 years with multimorbidity were also more likely to meet PA recommendations (aOR, 1.65: 95% CI 1.04-2.62) while women &lt;50 years were less likely to meet PA recommendations (p-interaction=0.02).
Conclusions: Our findings indicate that female cancer survivors with multimorbidity are more likely to be ever smokers and less likely to drink ≥2 alcoholic drinks/day. The associations between multimorbidity, alcohol consumption, and meeting PA recommendations significantly differed by race/ethnicity and age at cancer diagnosis. Identification of at risk groups of female cancer survivors with multimorbidity can help inform more targeted behavioral intervention studies among these women who are at increased risk of poor outcomes due to their chronic health conditions and cancer history.
Citation Format: Avonne E. Connor, Kate E. Dibble. Multimorbidity and healthy lifestyle behaviors among US-based female cancer survivors [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 LB554.