Cancer
Racial Disparities and Physical Activity in the Pathways Study, A Prospective Cohort Study of Breast Cancer Survivors Tanvi Srivastava* Tanvi Srivastava Lia L D’addario Janise M Roh Lawrence H Kushi
Physical activity (PA) is widely recognized for its numerous health benefits, including improved survival and quality of life in 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 (KPNC) provides a unique opportunity to explore these disparities in a comprehensive manner. A cohort of 4,504 women was enrolled soon after diagnosis from Jan 2006 to May 2013 with data collected through surveys, electronic health records, and other KPNC databases. Self-reported PA was assessed at baseline (~2 months post-diagnosis). Follow-up surveys were collected at around 6 and 24 months after baseline. The cohort is followed for outcomes such as recurrence, overall mortality, and cause-specific mortality. PA levels were defined as low, medium, and high based on MET-hour tertiles. Among 4,386 survivors with baseline PA data, 21% were foreign-born. Asian Americans (AA) had the highest percentage (48%) of college-educated patients and highest household incomes, with 41% earning $90,000+, while Non-Hispanic Blacks (NHB) had the lowest incomes, with 38% earning <$50,000. Poisson regression in the exploratory phase of this project showed that AA and NHB survivors were more likely to have lower PA levels (adj. RR for AA = 1.69 (1.42, 2.01); adj. RR for NHB = 1.24 (1.02, 1.51)) compared to NHW patients. AA survivors were less likely to have higher PA levels (adj. RR = 0.64 (0.53, 0.77)) compared to NHW patients. The next phase of this ongoing project is to investigate the associations of PA on BCa recurrence, BCa mortality, and mortality due to cardiovascular disease in this cohort across different racial and ethnic groups.