Purpose
U.S. cancer survivors commonly use vitamins/minerals and
complementary and alternative medicine (CAM). We compare use of
vitamins/minerals and CAM by adult cancer survivors and cancer-free adults,
and estimate annual out-of-pocket expenses.
Methods
Data on self-reported vitamin/mineral and CAM use in the past 12
months from the cross-sectional 2012 U.S. National Health Interview Survey
were used to estimate prevalence of use and out-of-pocket expenditures. The
cohort included adults with (n=2,977) and without (n=30,551) a self-reported
cancer diagnosis.
Results
Approximately 79% of cancer survivors and 68% of
cancer-free adults reported using ≥1 vitamins/minerals and/or CAM
modality in the past year. Compared to cancer-free adults, cancer survivors
were more likely to report use of vitamin/minerals (75% vs.
61%, P<0.001), herbal/non-vitamin supplements (24%
vs. 19%, P<0.001), manipulative and body-based therapies
(19% vs. 17%, P=0.03), and alternative medical systems
(5% vs. 4%, P=0.04). Adult cancer survivors and cancer-free
adults spent an annual estimated $6.7 billion and $52 billion out-of-pocket,
respectively, on vitamins/minerals and CAM. Survivors spent 60% of
the total on vitamins/minerals ($4 billion), 18% ($1.2 billion) on
herbal/non-vitamin supplements, and 7% ($0.5 billion) on
massage.
Conclusions
Compared with cancer-free adults, a higher proportion of cancer
survivors report vitamin/mineral and CAM use. Cancer survivors, who
accounted for 6.9% of the total population, accrued more than
11.4% of the annual out-of-pocket costs on vitamins/minerals and CAM
spent by U.S. adults.
Implications for Cancer Survivors
Given the high use of vitamins/minerals and CAM in cancer survivors,
studies are needed to analyze health outcomes and the cost:benefit ratio of
such use.
Purpose
Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA associates with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking.
Methods
We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using metabolic equivalent hours per week (MET-hrs∙wk−1), and walking was calculated using blocks per day (blocks∙d−1).
Results
The response rate to our survey was 43%. Among the 213 uterine cancer survivors in our survey, 36% were classified as having LLL. Compared with participants who reported <3 MET-hrs∙wk−1 of PA, participants who reported ≥18.0 MET-hrs∙wk−1 of PA had an odds ratio of LLL of 0.32 (95% CI: 0.15–0.69; Ptrend = .003). Stratified analyses suggested the association of PA and LLL existed only among women with a body mass index (BMI) <30 kg/m2 (Ptrend = .007), compared to women with a BMI ≥30 kg/m2 (Ptrend = .47). Compared with participants who reported <4.0 blocks∙d−1 of walking, participants who reported ≥12 blocks∙d−1 of walking had an odds ratio of LLL of 0.19 (95% CI: 0.09–0.43; Ptrend < .0001). Stratified analyses suggested the association of walking and LLL was similar among women with a BMI <30 kg/m2 (Ptrend = .007) and women with a BMI ≥30 kg/m2 (Ptrend = .03).
Conclusion
Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary, and investigated in future studies.
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