Abstract
Physical activity conveys numerous health benefits, including reduced risk for several cancers and promotion of cancer survivorship. Yet national levels of physical activity remain below national recommendations, particularly for black and Hispanic populations, who experience lower levels of activity and higher cancer mortality compared to whites. In light of current racial and ethnic disparities in physical activity and cancer, surveillance of public awareness of activity and cancer risk has important implications for population cancer control. Thus, the purpose of this study is twofold. First, we examine for differences between Non-Hispanic Blacks, Hispanics, Non-Hispanic Asian and Other (AI/AN and multiple races) racial/ethnic groups compared to Non-Hispanic Whites in awareness of exercise in reducing cancer risk, controlling for demographic, survey mode, and health characteristics. Second, we examine if differences in awareness of exercise in reducing cancer risk by racial/ethnic group varies by activity level, controlling for demographic, survey mode, and health characteristics.
The 2007 Health Information National Trends Survey (HINTS) was used to examine these issues. HINTS, a nationally representative, cross-sectional survey of the US civilian, non-institutionalized adult population, collected data using dual modes: a pencil and paper survey through mail and a telephone survey using random digit dialing. Data on awareness of exercise and cancer risk, activity, race/ethnicity, income, education, health characteristics (i.e. BMI, attempts to lose weight, and prior cancer diagnosis) were reported in both survey modes (n=5,616). Awareness of physical activity and cancer risk was measured using 1 item reported on a Likert scale, which was modified as a dichotomous variable: “physical activity or exercise decreases the chance of getting some type of cancer” or “does not make much difference.” Logistic regression examined differences between racial/ethnic groups on awareness of exercise and cancer risk. Data were weighted and analyzed using SUDAAN 9.0.
Overall, 61.8% of the sample reported physical activity decreases the chance of getting cancer. Logistic regression results indicate US Non-Hispanic Blacks had a 0.62 (95% CI=0.47,0.82) lower odds of reporting exercise “decreases the chance of getting cancer” versus “makes no difference” compared to Non-Hispanic Whites (50.4% among NH Blacks compared to 63.83% NH Whites), adjusting for demographic characteristics, survey mode, health characteristics, and activity level. While a greater percentage of Hispanics, Non-Hispanic Blacks and Non-Hispanic Asians were inactive compared to Non-Hispanic Whites, activity level did not explain observed differences between racial/ethnic groups on awareness. Stratified analysis found that among Hispanics, those trying to lose weight had a 2.07 (95% CI= 1.012,3.81) greater odds of reporting exercise “decreases the chance of getting cancer” compared to those who were not trying to lose weight. Among Non-Hispanic Blacks, those who had a cancer diagnosis had a 0.42 (95% CI=0.19,0.90) lower odds of reporting “decreases the chance of cancer” compared to those who did not. Results indicate a need for focused public health efforts in disseminating information and/or addressing beliefs regarding exercise and cancer risk among the U.S. Hispanic and Non-Hispanic black population.
Second AACR International Conference on the Science of Cancer Health Disparities— Feb 3–6, 2009; Carefree, AZ