Cancer
Racial Disparities and the Impact of Physical Activity on Mortality in the Pathways Study, A Prospective Cohort Study of Breast Cancer Survivors Tanvi Srivastava* Tanvi Srivastava Lia L D’addario Lawrence Kushi Janise M Roh
Physical activity (PA) is widely recognized for its numerous health benefits, including improved survival rates and quality of life for breast cancer (BCa) survivors. However, disparities in PA levels among different racial and ethnic groups have been documented. Understanding these disparities among BCa survivors is crucial for developing targeted interventions to promote PA among underserved populations. The diverse prospective cohort of BCa survivors in the Pathways study at Kaiser Permanente Northern California provides a unique opportunity to explore these disparities in a comprehensive manner. A cohort of 4,504 women was enrolled between Jan 2006 and May 2013 with data collected through surveys, EHR linkage, and other sources. As part of the cohort, self-reported PA data was collected at baseline (~2 months post-diagnosis). Follow-up surveys were collected at around 6 months and 24 months after baseline. The cohort is currently being followed for BCa outcomes including recurrence, overall mortality, and cause-specific mortality. PA levels were categorized as low, medium, and high based on MET-hour tertiles. Among 4,386 survivors, 21% were foreign-born. Asian Americans (AA) had the highest percentage (48%) of college-educated patients. AA survivors reported the highest household incomes, with 41% earning $90,000+, while Non-Hispanic Blacks (NHB) had the lowest incomes, with 38% earning <$50,000. Using Poisson regression, we found that AA and NHB survivors were more likely to have lower PA levels (adj. RR for AA = 1.69 (1.42, 2.01), p<0.01; adj. RR for NHB = 1.24 (1.02, 1.51), p=0.03) compared to NHW patients. AA survivors were less likely to have higher PA levels (adj. RR = 0.64 (0.53, 0.77), p<0.01) compared to NHW patients. The next objective of this project is to investigate the impact of PA on BCa recurrence, BCa mortality, and mortality due to cardiovascular disease amongst BCa survivors in the Pathways cohort across different racial/ethnic groups.