Physical activity and survival among Hispanic and non-Hispanic white long-term breast cancer survivors and population-based controls

Pinkston, Christina; Baumgartner, Richard N.; Connor, Avonne E.; Boone, Stephanie D.; Baumgartner, Kathy B.

doi:10.1007/s11764-015-0441-3

Cited by 12 publications

(9 citation statements)

References 41 publications

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“…To our knowledge, few studies have evaluated the association of physical activity and mortality in the U.S. Hispanic population. Our findings are different from those of the New Mexico Women's Health Study (NMWHS) 7 , where our colleagues suggested a significant reduction of all-cause mortality in Hispanic breast cancer survivors only. Differences in assessing and categorizing physical activity and the case-control design of the NMWHS may account for the differences in findings.…”

Section: Discussioncontrasting

confidence: 99%

“…The characteristics of Hispanic women in our study were similar to the New Mexico breast cancer population in other studies. NMWHS reported that household activities took up 62.2% of total activity in Hispanic women and 52.9% in non-Hispanic White women 7 . Hispanic women are also considered to have a higher prevalence of overweight and obesity compared to non-Hispanic Whites in the general population 25 .…”

Section: Discussionmentioning

confidence: 99%

“…The primary limitation is the small sample size. Compared to a similar study evaluating the association between physical activity and survival among breast cancer survivors by ethnicity, NMWHS (722 participants) 7 , we had a smaller study population. Our smaller study may have limited our power to observe and interpret the true association.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have suggested that being physically active has a positive effect on physical and psychological levels: the underlying mechanisms might include regulation of sex hormones, metabolic hormones, adipokines, oxidative stress, and immune function 5 . Among women with breast cancer, there is accumulating epidemiological evidence indicating that survivors participating in physical activity of moderate to vigorous intensity have reduced all-cause mortality, breast cancer-specific mortality, risk of cancer-related symptoms, and improved physical health-related quality of life after their breast cancer diagnosis 6,7 . A systematic review by Lahart and colleagues 8 found significant risk reductions for all-cause and breast cancer-related death for higher level of lifetime prediagnosis recreational physical activity (hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.70-0.96, and HR 0.73, 95% CI 0.54-0.98, respectively), higher level of more recent prediagnosis physical activity (HR 0.73, 95% CI 0.65-0.82; and HR 0.84, 95% CI 0.73-0.97, respectively), and higher level of postdiagnosis physical activity (HR 0.52, 95% CI 0.43-0.64; and HR 0.59, 95% CI 0.45-0.78, respectively).…”

Section: Introductionmentioning

confidence: 99%

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Ethnic and biological differences in the association between physical activity and survival after breast cancer

et al. 2020

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Physical activity is recommended for most cancer patients as a nonpharmacological therapy to improve prognosis. Few studies have investigated the association between physical activity and breast cancer prognosis by ethnicity, biological, and modifiable risk factors for mortality. We investigated the association between physical activity and long-term survival among breast cancer survivors. A total of 397 survivors (96 Hispanic and 301 non-Hispanic White (NHW)) from the New Mexico HEAL study contributed baseline and biological data approximately 6 months after diagnosis. Study outcomes included all-cause, breast cancer-specific, and non-breast cancer mortality. The exposure was self-reported physical activity within the past month. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox Proportional Hazards regression. A total of 133 deaths (53 breast cancer-specific deaths) were observed after a median follow-up time of 13 years. Engaging in >6.9 metabolic equivalent hours/week (MET-h/week) of moderate to vigorous physical activity (active) was inversely associated with all-cause mortality among all women (HR 0.66, 95% CI 0.43–0.99) and NHWs (HR 0.58, 95% CI 0.36–0.94). Active NHW women also had a reduced risk of non-breast cancer mortality (HR 0.56, 95% CI 0.31–0.99), compared to inactive women (0 MET-h/week). In subgroups, we observed the inverse associations with all-cause mortality among women >58 years old (p-interaction= 0.03) and with localized stage (p-interaction = 0.046). Our results confirm the protective association between physical activity and mortality after breast cancer diagnosis, and demonstrate that this association significantly differs by age and cancer stage. Larger studies are warranted to substantiate our findings.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ethnic and biological differences in the association between physical activity and survival after breast cancer

et al. 2020

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“…An increase in physical activity has been shown to decrease breast cancer mortality overall (112) and in Hispanic women, specifically (113). Higher physical activity is predictive of better HRQOL in women diagnosed with breast cancer (64,65).…”

Section: Lifestyle and Physical Factorsmentioning

confidence: 99%

Post-diagnosis quality of life and mortality in non-Hispanic White and Hispanic women diagnosed with invasive breast cancer.

Mattingly¹

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Geographical Variation in Social Determinants of Female Breast Cancer Mortality Across US Counties

Anderson,

Herrera,

Mireku

et al. 2023

JAMA Netw Open

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ImportanceBreast cancer mortality is complex and traditional approaches that seek to identify determinants of mortality assume that their effects on mortality are stationary across geographic space and scales.ObjectiveTo identify geographic variation in the associations of population demographics, environmental, lifestyle, and health care access with breast cancer mortality at the US county-level.Design, Setting, and ParticipantsThis geospatial cross-sectional study used data from the Surveillance, Epidemiology, and End Results (SEER) database on adult female patients with breast cancer. Statistical and spatial analysis was completed using adjusted mortality rates from 2015 to 2019 for 2176 counties in the US. Data were analyzed July 2022.ExposuresCounty-level population demographics, environmental, lifestyle, and health care access variables were obtained from open data sources.Main Outcomes and MeasuresModel coefficients describing the association between 18 variables and age-adjusted breast cancer mortality rate. Compared with a multivariable linear regression (OLS), multiscale geographically weighted regression (MGWR) relaxed the assumption of spatial stationarity and allowed for the magnitude, direction, and significance of coefficients to change across geographic space.ResultsBoth OLS and MGWR models agreed that county-level age-adjusted breast cancer mortality rates were significantly positively associated with obesity (OLS: β, 1.21; 95% CI, 0.88 to 1.54; mean [SD] MGWR: β, 0.72 [0.02]) and negatively associated with proportion of adults screened via mammograms (OLS: β, −1.27; 95% CI, −1.70 to −0.84; mean [SD] MGWR: β, −1.07 [0.16]). Furthermore, the MGWR model revealed that these 2 determinants were associated with a stationary effect on mortality across the US. However, the MGWR model provided important insights on other county-level factors differentially associated with breast cancer mortality across the US. Both models agreed that smoking (OLS: β, −0.65; 95% CI, −0.98 to −0.32; mean [SD] MGWR: β, −0.75 [0.92]), food environment index (OLS: β, −1.35; 95% CI, −1.72 to −0.98; mean [SD] MGWR: β, −1.69 [0.70]), exercise opportunities (OLS: β, −0.56; 95% CI, −0.91 to −0.21; mean [SD] MGWR: β, −0.59 [0.81]), racial segregation (OLS: β, −0.60; 95% CI, −0.89 to −0.31; mean [SD] MGWR: β, −0.47 [0.41]), mental health care physician ratio (OLS: β, −0.93; 95% CI, −1.44 to −0.42; mean [SD] MGWR: β, −0.48 [0.92]), and primary care physician ratio (OLS: β, −1.46; 95% CI, −2.13 to −0.79; mean [SD] MGWR: β, −1.06 [0.57]) were negatively associated with breast cancer mortality, and that light pollution was positively associated (OLS: β, 0.48; 95% CI, 0.24 to 0.72; mean [SD] MGWR: β, 0.27 [0.04]). But in the MGWR model, the magnitude of effect sizes and significance varied across geographical regions. Inversely, the OLS model found that disability was not a significant variable for breast cancer mortality, yet the MGWR model found that it was significantly positively associated in some geographical locations.Conclusions and RelevanceThis cross-sectional study found that not all social determinants associated with breast cancer mortality are spatially stationary and provides spatially explicit insights for public health practitioners to guide geographically targeted interventions.

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Physical activity and survival among Hispanic and non-Hispanic white long-term breast cancer survivors and population-based controls

Abstract: Public health programs in Hispanic communities should promote physical activity in women as a means of decreasing breast cancer risk and improving survival.

Cited by 12 publications

References 41 publications

Ethnic and biological differences in the association between physical activity and survival after breast cancer

Ethnic and biological differences in the association between physical activity and survival after breast cancer

Post-diagnosis quality of life and mortality in non-Hispanic White and Hispanic women diagnosed with invasive breast cancer.

Geographical Variation in Social Determinants of Female Breast Cancer Mortality Across US Counties

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