Little is known about the contribution of diet components independent of body composition to persistent fatigue in breast cancer survivors. Therefore, our study aim was to determine the associations among dietary intake and fatigue in relation to and independent of adiposity and physical activity (PA) in breast cancer survivors. Baseline data from 42 breast cancer survivors enrolled in a randomized exercise trial were analyzed: fatigue (FACT-F), diet components (3-day diet record), body mass index, percent body fat (DXA), and PA (accelerometer). The mean age was 54±9 years with an average BMI of 30.5±8.1 kg/m2. Fatigue was positively associated with % of kcal/day fat intake (r=.31, p<.05) and inversely related to fibre g/day (r=.38, p<.05) and carbohydrate g/day intake (r=.31, p<.05). Mean fatigue was greater for participants eating <25 g/day of fibre compared with >25 g/day of fibre (15.7±10.8 versus 6.4±3.7, p<.005). No significant associations were noted between fatigue and PA or body composition. Diets high in fibre and low in fat are associated with reduced fatigue in breast cancer survivors. The difference in fatigue for low versus high fibre diets exceeded the minimal clinically important difference of 3 units. Prospective studies evaluating the effect of changing diet on fatigue in breast cancer survivors are warranted.

PURPOSE: Financial hardship is increasingly understood as a negative consequence of cancer and its treatment. As patients with cancer face financial challenges, they may be forced to make a trade-off between food and medical care. We characterized food insecurity and its relationship to treatment adherence in a population-based sample of cancer survivors. METHODS: Individuals 21 to 64 years old, diagnosed between 2008 and 2016 with stage I-III breast, colorectal, or prostate cancer were identified from the New Mexico Tumor Registry and invited to complete a survey, recalling their financial experience in the year before and the year after cancer diagnosis. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95%CIs. RESULTS: Among 394 cancer survivors, 229 (58%) were food secure in both the year before and the year after cancer diagnosis (persistently food secure), 38 (10%) were food secure in the year before and food insecure in the year after diagnosis (newly food insecure), and 101 (26%) were food insecure at both times (persistently food insecure). Newly food-insecure (OR, 2.82; 95% CI, 1.02 to 7.79) and persistently food-insecure (OR, 3.04; 95% CI,1.36 to 6.77) cancer survivors were considerably more likely to forgo, delay, or make changes to prescription medication than persistently food-secure survivors. In addition, compared with persistently food-secure cancer survivors, newly food-insecure (OR, 9.23; 95% CI, 2.90 to 29.3), and persistently food-insecure (OR, 9.93; 95% CI, 3.53 to 27.9) cancer survivors were substantially more likely to forgo, delay, or make changes to treatment other than prescription medication. CONCLUSION: New and persistent food insecurity are negatively associated with treatment adherence. Efforts to screen for and address food insecurity among individuals undergoing cancer treatment should be investigated as a strategy to reduce socioeconomic disparities in cancer outcomes.

Importance Germline variants in the MC1R gene are common and confer moderate melanoma risk in those with varied skin types. Approaches to precision skin cancer prevention that include genetic information may promote risk awareness and risk reduction in the general population, including Hispanics. Objective To examine prevalence of interest in and uptake of MC1R testing in the general population and examine patterns across demographic and skin cancer risk factors. Design A randomized controlled trial examined interest in and uptake of MC1R testing. Study participants were randomized to either a usual care condition (NCI skin cancer pamphlet for diverse skin types) or an MC1R test offer. Setting University of New Mexico General Internal Medicine clinics. Participants Participants were registered clinic patients (≥ 6 months) and English or Spanish fluent. Of the N=600 recruited to the overall trial, the current study included those 499 participants randomized to the MC1R test offer (44% non-Hispanic white, 49% Hispanic, 79% female; mean age=54). Intervention Participants were presented with the option to log onto the study website to read three educational modules presenting the rationale, benefits and drawbacks of MC1R testing. Main Outcomes and Measures Main outcomes include website logon (yes vs. no), saliva test kit request (yes vs. no), and saliva test kit return for MC1R testing (yes vs. no). Demographic and skin cancer risk factors were examined as potential predictors of test interest and uptake. Results About half of participants (46%, n=232) elected to learn about MC1R testing by logging onto the website; most that logged on decided to request testing (88%, n=204); and most who requested testing returned the kit (82%, n=167). The strongest predictors of website logon were race/ethnicity and education (non-Hispanic whites and more highly educated were more likely to log on); the strongest predictor of ordering the test was sunburn history. Conclusion and Relevance There were moderately high levels of MC1R test interest and uptake in this diverse sample. Addressing potential barriers to testing may be warranted as genomic information becomes integrated into general population approaches to the precision prevention of skin cancer.

NCT03326713; clinicaltrials.gov.