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Quality of Life
Functional Impairment and Physical Activity Adherence Among Gynecologic Cancer Survivors: A Population-Based Study
  1. Pratibha Nayak, PhD, MPH*,†,
  2. Sally W. Vernon, PhD†,
  3. Lara S. Savas, PhD†,
  4. Karen Basen-Engquist, PhD‡,
  5. Robert O. Morgan, PhD§ and
  6. Linda S. Elting, DrPH∥
  1. *Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX;
  2. †Department of Health Promotion and Behavioral Sciences,
  3. ‡Department of Behavioral Sciences, and
  4. §Department of Management, Policy and Community Health, The University of Texas School of Public Health, Houston, TX; and
  5. ∥Department of Health Services, The University of Texas MD Anderson Cancer Center, Houston, TX.
  1. Address correspondence and reprint requests to Pratibha Nayak, PhD, MPH, Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1400 Herman Pressler St, Houston, TX 77030. E-mail: pnayakph@gmail.com.

Abstract

Objective Adherence to physical activity guidelines after cancer diagnosis improves physical functioning. The purpose of this study was to estimate the prevalence of physical activity in a population-based sample of gynecologic cancer survivors (GCSs) and to examine the association between functional impairment and adherence to physical activity guidelines.

Methods Using the 2009 Behavioral Risk Factor Surveillance System survey, we identified 5,015 GCSs aged 20 years or older who were 1 year or more after diagnosis. We used multinomial logistic regression with survey weighting to examine the association between functional impairment and adherence to physical activity guidelines (using 3 levels: sedentary, somewhat active, and meeting physical activity guidelines), controlling for demographic and clinical factors.

Results We found that 55% of GCSs did not adhere to physical activity guidelines and that 38% reported functional impairment. Gynecologic cancer survivors with functional impairment were less likely to meet guidelines (adjusted odds ratio [AOR], 0.34; 95% confidence interval [CI], 0.25–0.47) or to be somewhat active (AOR, 0.43; 95% CI, 0.31–0.59) compared with those without impairment. Having more than high school education (AOR, 1.66; 95% CI, 1.15–2.40), fewer comorbidities (AOR, 0.55; 95% CI, 0.33–0.91), and not being obese (OR, 0.53; 95% CI, 0.36–0.77) were associated with meeting physical activity guidelines compared with being sedentary.

Conclusions Gynecologic cancer survivors do not meet physical activity guidelines and experience functional impairment, which is associated with lower adherence to physical activity recommendations. Prospective studies are needed to better elucidate the relation between functional impairment and physical activity.

  • Cancer
  • Physical activity
  • Impairment
  • Behavioral risk factor surveillance system
  • Gynecologic

https://doi.org/10.1097/IGC.0000000000000620

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    Footnotes

    • This research was supported by funds from the University Cancer Foundation and the Duncan Family Institute for Cancer Prevention and Risk Assessment via the Cancer Survivorship Research Seed Money Grants at The University of Texas MD Anderson Cancer Center, and from the Cancer Prevention and Research Institute of Texas through the CERCIT grant (Grant No. RP101207 P04 02- L. Elting, PI) to the University of Texas Medical Branch at Galveston. Dr Basen-Engquist is supported by the Center for Energy Balance in Cancer Prevention and Survivorship, Duncan Family Institute for Cancer Prevention and Risk Assessment.

    • The authors declare no conflicts of interest.

    • Presented as a poster at the 34th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine Conference, March 2013, San Francisco, CA.

    • This study is a secondary data analysis and uses publicly available data set. The data could be accessed from CDC BRFSS website (http://www.cdc.gov/brfss/annual_data/annual_2009.htm) for purpose of reviewing.