ASPO Abstracts
Multilevel Risk Factors for Weight Change after Breast Cancer Diagnosis Among Black Women
Category: Cancer Health Disparities
Conference Year: 2021
Abstract Body:
Background: Weight gain after breast cancer diagnosis increases the risk of mortality. African American/Black breast cancer
survivors are more likely to have excess body weight than their White counterparts, which may contribute to their higher mortality
rate. Emerging evidence suggests that post-diagnosis weight gain may result from multilevel determinants. However, no study
has investigated the multilevel characteristics among Black breast cancer survivors.
Objective: To evaluate associations between individual-level factors and neighborhood social and built environment factors with
weight change after breast cancer diagnosis among Black women.
Methods: We evaluated associations of interest among 785 women enrolled in the Women's Circle of Health Follow-Up Study
(WCHFS), a longitudinal study of Black breast cancer survivors in New Jersey. Weight change was primarily based on
measurements at baseline and follow-up visits (Median: 10.3 and 23.2 mo. since diagnosis, respectively). Participants were
grouped into categories of stable weight (52.4%), ≥3% weight loss (20.0%), and ≥3% weight gain (27.6%). Using multivariate-
adjusted multinomial logistic regression and multilevel multinomial logistic regression, we evaluated relative risk ratios (RRRs) for
associations between multilevel factors and post-diagnosis weight change category.
Results: Black breast cancer survivors who were older at diagnosis, had higher household income, post-menopausal status, and
higher baseline BMI were less likely to gain weight compared to women with stable weight. Former smoking, higher tumor stage,
and chemotherapy were associated with increased relative risk of weight gain (e.g. RRR-chemo: 1.45, 95% CI: 1.01, 2.08). Black
women residing in neighborhoods in the highest tertile for density of walkable destinations had a decreased relative risk of post-
diagnosis weight gain (e.g. RRR-T3 highest density vs. T1 lowest: 0.39, 95% CI: 0.20, 0.75), while those residing in
neighborhoods with higher density of fast food restaurants had increased relative risk of weight gain (RRR-T3 highest density vs.
T1 lowest: 1.94, 95% CI: 1.23, 3.05).
Conclusion: Both individual and neighborhood factors may influence the risk of weight gain among Black women after breast
cancer diagnosis.
Keywords: Black breast cancer survivors, post-diagnosis weight change, multilevel risk factors