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Physical activity in association with mortality among Black women diagnosed with breast cancer in the Southern Community Cohort Study

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Abstract

Purpose

Physical activity (PA) is associated with many health benefits. While PA has been associated with reduced mortality after breast cancer diagnosis in many studies, few studies have examined the role of PA in breast cancer survival among underserved and minority populations, including Black women. We investigated PA in association with mortality among Black predominantly low-income breast cancer survivors in the Southern Community Cohort Study (SCCS).

Methods

Study participants were women diagnosed with incident breast cancer (n = 949) in the SCCS, which is a prospective cohort study of predominantly low-income adults aged 40–79 years recruited from 12 Southeastern states between 2002 and 2009. Participants completed a detailed baseline questionnaire, with annual follow-up for mortality via registry linkages. Cox regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations of pre-diagnosis PA (measured via a validated questionnaire) with all-cause and breast cancer-specific mortality.

Results

Breast cancer survivors had a mean age of 61.1 years and most (79.3%) had a household income of < $25,000. In adjusted models, higher levels of total PA (MET-hours/day) were inversely associated with all-cause mortality with HRs (95% CIs): 0.79 (0.59–1.06), 0.66 (0.49–0.90), and 0.60 (0.43–0.84), for Q2, Q3, and Q4 (reference: Q1), respectively, ptrend ≤ 0.01. A similar inverse association was found for breast cancer-specific mortality.

Conclusion

Higher levels of pre-diagnosis PA were associated with improved survival among low-income Black breast cancer survivors. Resources to reduce barriers to PA participation and increase support for education and intervention efforts to promote PA among Black women are needed.

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Data availability

Access to SCCS data is overseen by the SCCS Data and Biospecimen Use Committee, which meets on regular basis. Researchers may gain access to the SCCS data by submitting a request through the SCCS Online Request System with more details available at: https://www.southerncommunitystudy.org/research-opportunities.html.

Abbreviations

BMI:

Body mass index

CI:

Confidence interval

ER:

Estrogen receptor status

HR:

Hazard ratio

HER2:

Human epidermal growth factor receptor 2

NDI:

National Death Index

MET:

Metabolic equivalents

PA:

Physical activity

PR:

Progesterone receptor status

SEER:

Surveillance, epidemiology, and end results

SCCS:

Southern Community Cohort Study

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Acknowledgments

This work was supported by the National Cancer Institute of the National Institutes of Health under Award Number U01CA202979. Southern Community Cohort Study data collection was performed by the Survey and Biospecimen Shared Resource which is supported in part by the Vanderbilt-Ingram Cancer Center (P30 CA68485). This research was also partly supported by grants R03CA171013 and K07CA184257 from the National Cancer Institute.

Funding

This work was supported by the National Cancer Institute of the National Institutes of Health under Award Number U01CA202979. SCCS data collection was performed by the Survey and Biospecimen Shared Resource which is supported in part by the Vanderbilt-Ingram Cancer Center (P30 CA68485). This research was also partly supported by grants R03CA171013 and K07CA184257 from the National Cancer Institute.

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Contributions

All authors contributed to the study conception and study design. The data analysis was conducted by SN. The first draft of the manuscript was written by SN. All authors contributed interpretation of results, writing of the manuscript and revising the manuscript for critically for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sarah J. Nechuta.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

All participants provided written informed consent, and the SCCS was approved by the institutional review boards at Vanderbilt University Medical Center and Meharry Medical College.

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Nechuta, S.J., Lipworth, L., Chen, W.Y. et al. Physical activity in association with mortality among Black women diagnosed with breast cancer in the Southern Community Cohort Study. Cancer Causes Control 34, 277–286 (2023). https://doi.org/10.1007/s10552-022-01663-x

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