Background: While major cancer risk factors (CRFs) are well documented in the US general population, their burden in 16.9 million US cancer survivors has not been described. Continued CRF exposure may contribute to recurrence, second cancers, and other chronic disease risks. Using US representative surveys, we previously reported high CRF prevalences in cancer survivors. To better target health-promoting interventions, sub-populations of survivors with higher CRF burdens need to be identified, especially racial/ethnic minorities who have higher cancer-specific and other chronic disease mortality rates. Thus, we quantified CRF prevalences and trends in cancer survivors by major US racial/ethnic minorities and compared with non-Hispanic Whites (NHW) over 12 years. Methods: We analyzed data for 455 non-Hispanic Black [NHB], 389 Hispanic, and 1739 NHW cancer survivors (self-reported MD diagnosis of cancer except non-melanoma skin) >20 years old who participated in the 2005-16 National Health and Nutrition Examination Surveys. We estimated unadjusted race/ethnicity-specific prevalences of major CRFs – current smoking, alcohol (>2 drinks/day), overweight/obesity (BMI>25 kg/m2), physical inactivity (<10 mins moderate activity/day), self-reported poor/fair diet, and diabetes history – and prevalence trends. We estimated age- and sex-adjusted CRF prevalence ratios and comparing NHB and Hispanic to NHW survivors using Poisson regression. Results: Median time since diagnosis (8 years) did not differ by race/ethnicity. Hispanic survivors were younger and more likely female compared to NHW and NHB survivors. Adjusting for age and sex, compared to NHW survivors, smoking prevalence was 35% higher in NHB survivors but did not differ in Hispanic survivors, and alcohol prevalence was 44% higher in Hispanic survivors, but did not differ in NHB survivors. In both NHB and Hispanic survivors, prevalences of overweight/obesity (NHB 12%, Hispanic 20%), physical inactivity (27%, 20%), poor/fair diet, (48%, 42%), and diabetes history (121%, 98%) were statistically significantly higher than in NHW survivors. CRF prevalences were significantly higher in NHB and Hispanic compared to NHW survivors over 12 years. Conclusions: CRF prevalences are disproportionately higher in Hispanics and NHB compared to NHW cancer survivors, accounting for age and sex, and these patterns have persisted over time. These US nationally representative data may be used to direct interventions for specific CRFs to specific racial/ethnic minority subpopulations of cancer survivors to increase wellbeing.

Citation Format: Chinenye C Ugoji, Lorraine T Dean, Elizabeth A Platz. Excess burden of major cancer risk factors in racial/ethnic minority adult cancer survivors in the United States (2005–2016) [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 D099.