Healthy Lifestyle Impact on Breast Cancer-Specific and All-Cause Mortality

Grade Level at Time of Presentation

Senior

Major

Public Health

Minor

Biology

Institution

University of Louisville

KY House District #

40

KY Senate District #

35

Department

Department of Epidemiology and Population Health

Abstract

Healthy Lifestyle Impact on Breast Cancer-Specific and All-Cause Mortality Adaline E. Heitz1, Stephanie D. Boone, PhD, MPH2, Delvon T. Mattingly, B.S.1, Richard N. Baumgartner, PhD2, Kathy B. Baumgartner, PhD2 R25 Program1 and Department of Epidemiology & Population Health, School of Public Health & Information Sciences, and James Graham Brown Cancer Center2

Individual lifestyle factors have long been associated with cancer mortality. The impact of these factors has been evaluated in combination through the creation of a healthy behavior index (HBI), but this relationship has not been extensively evaluated in minority populations. This study constructed an HBI to evaluate the impact of modifiable factors on breast cancer specific and all-cause mortality in non-Hispanic white (NHW) and Hispanic (H) women. Diet and lifestyle questionnaires were completed by women (n=837 cases) diagnosed with invasive breast cancer between 1999 and 2004 as part of the 4-Corners Women’s Health Study. A score ranging from 0-12 was assigned based on dietary pattern, physical activity, smoking, alcohol consumption, and body size and shape, with a lower score representing greater adherence to national guidelines. An increased risk of breast cancer-specific mortality for HBI Q2-Q4 compared to Q1 was present but was not statistically significant overall by ethnicity or stage of disease. A significantly increasing trend across HBI quartiles was observed among all women, NHW women, and those diagnosed with localized or regional/distant stage of disease for all-cause (AC) mortality (p-trend=0.006, 0.002, 0.03, respectively). A significant >2-fold increased risk of AC mortality was observed for all women and NHW women in HBI Q4 vs. Q1 (HR=2.18, 2.65, respectively). These findings indicate an association between the HBI and all-cause mortality and are suggestive of an association between the HBI and breast-cancer specific mortality. However, the influence of the HBI appears to differ by ethnicity and stage at diagnosis.

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Healthy Lifestyle Impact on Breast Cancer-Specific and All-Cause Mortality

Healthy Lifestyle Impact on Breast Cancer-Specific and All-Cause Mortality Adaline E. Heitz1, Stephanie D. Boone, PhD, MPH2, Delvon T. Mattingly, B.S.1, Richard N. Baumgartner, PhD2, Kathy B. Baumgartner, PhD2 R25 Program1 and Department of Epidemiology & Population Health, School of Public Health & Information Sciences, and James Graham Brown Cancer Center2

Individual lifestyle factors have long been associated with cancer mortality. The impact of these factors has been evaluated in combination through the creation of a healthy behavior index (HBI), but this relationship has not been extensively evaluated in minority populations. This study constructed an HBI to evaluate the impact of modifiable factors on breast cancer specific and all-cause mortality in non-Hispanic white (NHW) and Hispanic (H) women. Diet and lifestyle questionnaires were completed by women (n=837 cases) diagnosed with invasive breast cancer between 1999 and 2004 as part of the 4-Corners Women’s Health Study. A score ranging from 0-12 was assigned based on dietary pattern, physical activity, smoking, alcohol consumption, and body size and shape, with a lower score representing greater adherence to national guidelines. An increased risk of breast cancer-specific mortality for HBI Q2-Q4 compared to Q1 was present but was not statistically significant overall by ethnicity or stage of disease. A significantly increasing trend across HBI quartiles was observed among all women, NHW women, and those diagnosed with localized or regional/distant stage of disease for all-cause (AC) mortality (p-trend=0.006, 0.002, 0.03, respectively). A significant >2-fold increased risk of AC mortality was observed for all women and NHW women in HBI Q4 vs. Q1 (HR=2.18, 2.65, respectively). These findings indicate an association between the HBI and all-cause mortality and are suggestive of an association between the HBI and breast-cancer specific mortality. However, the influence of the HBI appears to differ by ethnicity and stage at diagnosis.