title: Racial and ethnic differences in health behaviors among cancer survivors.
abstract: BACKGROUND
  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.
authors.affiliation: Department of General Internal Medicine, University of Texas MD Anderson Cancer Center; Health Promotion and Behavioral Sciences, University of Texas Health Science Center, Houston. Electronic address: pnayak@mdanderson.org.
authors.forename: Pratibha
authors.initials: P
authors.lastname: Nayak
authors.affiliation: Department of Behavioral and Community Health, University of North Texas Health Science Center, Fort Worth, Texas.
authors.forename: Raheem J
authors.initials: RJ
authors.lastname: Paxton
authors.affiliation: Department of General Internal Medicine, University of Texas MD Anderson Cancer Center.
authors.forename: Holly
authors.initials: H
authors.lastname: Holmes
authors.affiliation: Department of Health Services Research; University of Texas MD Anderson Cancer Center.
authors.forename: Hoang
authors.initials: H
authors.lastname: Thanh Nguyen
authors.affiliation: Department of Health Services Research; University of Texas MD Anderson Cancer Center.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Elting
mesh_terms: D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D004032:Diet / Q000208:ethnology; D005006:Ethnicity; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology* / Q000401:mortality; D009765:Obesity / Q000208:ethnology; D015995:Prevalence; D044469:Racial Groups