Purpose: Poor sleep quality is a long-term adverse effect of cancer treatment and is associated with poor quality of life (QOL). Physical activity (PA) improves sleep quality, yet rural cancer survivors are less likely to do PA and report poorer QOL than those residing in urban areas. This study evaluated the association between sleep quality and QOL among rural cancer survivors in central Pennsylvania and explored the impact of PA on sleep quality in this underserved population. Method: Rural cancer survivors were recruited to the Partnering to Prevent and Control Cancer study, a cross-sectional study to explore factors related to PA in rural cancer survivors living in central Pennsylvania. Participants (N=219) completed questionnaires assessing sociodemographics, sleep quality, QOL (physical and social functioning, role limitations due to physical health and emotional problems, fatigue, emotional well-being, pain, and general health), and weekly leisure-time PA (WLPA). Independent samples t-tests were used to explore associations between poor sleep quality and QOL indicators, and logistic regression was used to explore the association between WLPA and sleep quality. Results: Participants (60.7% female; M age=64.5±12.2 years; M BMI=29.6±6.9 kg/m2) were mostly breast (30.6%) or prostate (27.4%) cancer survivors and were more than 12 weeks but less than 5 years post-treatment (90.4%). Most participants had completed college (25.7%) or less (49.5%) and reported an annual household income ≥$40,000 (80.5%). Over half (59.7%) of rural cancer survivors reported poor sleep quality, and 57.8% were not meeting PA recommendations of ≥150 minutes of WLPA/week. Poor sleep quality was associated with poorer QOL for all indicators (ps<.05). Rural cancer survivors who were moderately active (OR=0.4, 95% CI: 0.2-0.8) or meeting PA recommendations (OR=0.5, 95% CI: 0.2-0.9) were less likely to report poor sleep quality, and those meeting PA recommendations were more likely to report higher QOL (OR=18.1, 95% CI: 4.1-80.3) than those who were inactive. Conclusions: Rural cancer survivors in PPCC report poorer sleep quality and QOL and engage in less PA than urban cancer survivors, contributing to cancer health disparities. Interventions are needed to increase PA in an effort to improve sleep quality and physical and psychological health. Furthermore, interventions and survivorship care plans must be designed to meet the unique physical and psychological needs of this underserved population to reduce long-term adverse effects of cancer treatment in rural cancer survivors.
Citation Format: Scherezade K Mama, Nishat Bhuiyan, Kathryn H Schmitz. Impact of physical activity and sleep quality on quality of life in rural cancer survivors in central Pennsylvania [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D060.