Racial and ethnic differences in health behaviors among cancer survivors.

Introduction: Previous studies of health behaviors of adult cancer survivors have not adequately examined racial and ethnic differences because of small sample sizes. A national data set was used to examine differences in health behaviors between cancer survivors and controls and between racial and ethnic groups among survivors.

Methods: The study analyzed 2009 Behavioral Risk Factor Surveillance System survey data in 2012-2014. Descriptive statistics were used to examine differences in health behaviors between cancer survivors and controls aged 20-64 years. Multivariable analysis was conducted to examine associations between race/ethnicity (white, African American, Hispanic, Asian, or Native American) and health behaviors (BMI, fruit and vegetable consumption, physical activity, and smoking status) while adjusting for demographic and medical characteristics. Significance was set at p<0.01.

Results: Compared with controls (n=245,283), cancer survivors (n=17,158) had higher prevalence rates for overweight/obese status (67% vs 65%); not meeting physical activity recommendations (53% vs 49%); and current smoking status (22% vs 20%). In the multivariable model, diet and smoking behavior differed across cancer status. African American (AOR=1.95) and Hispanic (AOR=2.06) survivors were more likely to have higher BMI than white survivors. African American survivors (AOR=1.6) were less likely to meet physical activity guidelines. Native American (AOR=3.08) and multiracial (AOR=1.74) survivors were more likely to be current smokers than non-Hispanic white survivors.

Conclusions: This study suggests that racial and ethnic differences exist in the adoption of recommended health behaviors; future research should identify factors to reduce these differences.