ASPO Abstracts
Racial/ethnic differences in healthy lifestyle promotion in older cancer survivors: Data from 12 cancer centers in the Southeastern U.S.
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Purpose: To better understand potential gaps in healthy lifestyle (HLS) counseling from medical providers this
analysis investigates racial/ethnic differences in the occurrence of HLS discussions between older cancer
survivors and their providers.
Methods: This secondary data analysis utilized cross-sectional survey data from cancer survivors (≥65 years)
seen at 12 cancer centers in the Southeastern U.S. during 2013-2015. The main outcome was self-report of HLS
discussions regarding exercise, diet, or weight management with providers (oncologists, nurses, and/or another
doctor). Race/ethnicity was categorized as white and minority (African-American, and other). Descriptive statistics
were calculated for survivor demographic and clinical data. Bivariate comparisons were calculated. Odds ratios
(OR) and 95% confidence intervals (CI) compared odds of HLS discussions by race/ethnicity using multivariable
logistic regression.
Results: This sample included 1,460 cancer survivors of mean age 74 years (SD 6). Our sample was majority
white (81%), female (60%), college-educated (62%), >1 year post-diagnosis (84%), and overweight and/or obese
(64%). Compared to white survivors, minority survivors were less often college-educated (51% vs. 65%), more
often younger (67% vs. 56%), obese (40% vs. 25%), and more often reported pain (66% vs. 58%) and distress
(59% vs.49%). A higher proportion of minority survivors reported discussing exercise (59% vs. 47%), healthy diet
(61% vs. 52%), vegetable consumption (38% vs. 26%), and weight loss (41% vs. 31% respectively) with their
providers than white survivors. After adjusting for demographic and clinical characteristics, minority survivors had
higher odds of HLS discussions regarding exercise (OR 1.4, 95% CI 1.08-1.90), vegetable consumption (OR 1.5,
95% CI 1.12-2.03), and on all three main HLS topics (exercise, diet, and vegetables) (OR 1.4, 95% CI 1.04-2.07).
Similar to white respondents, minorities reported discussing HLS with another doctor more often than with
oncologists and nurses.
Conclusion: Additional studies are needed to understand reasons for differences in HLS discussions in each
racial/ethnic survivor group. Strategies are needed to increase oncologists and nurses' promotion of HLS
discussions in older adults.
Keywords: healthy lifestyle promotion, cancer survivorship, cancer health disparities