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Patterns of Physical Activity and the Role of Obesity and Comorbidities Among Long-term African American Breast Cancer Survivors



Physical activity (PA) has many health benefits for cancer survivors, but little research has examined patterns and correlates in African American women, who have a higher burden of comorbidities and obesity. We examined PA types and patterns overall and by obesity and comorbidities among long-term (> 5 years) breast cancer survivors.


This cross-sectional study included 323 women who were previous participants of a case-only study in three southeastern states. Women completed a survivorship-focused questionnaire using validated measures to collect data on cancer treatment, PA (recreational, household, transportation) and other lifestyle factors, and comorbidities. Logistic regression models estimated adjusted ORs and 95% CIs for total PA (all three types, categorized as tertiles) and meeting PA guidelines (> 150 min/week of exercise).


The mean age of women was 59.1 years (range 27.9–79.5). The most frequent PA types (≥ 1/month) included routine household cleaning (92.9%), shopping (94.7%), walking slowly (42.1%), and walking briskly (40.6%). Less than 40% met PA guidelines. Women with more total comorbidities, arthritis, and obesity had lower levels of total PA (minutes/week) and/or recreational PA. In adjusted models, BMI ≥ 35 kg/m2 was associated with reduced odds of total PA (OR = 0.33, 95% CI 0.12–0.88, highest tertile). Arthritis was associated with reduced odds of meeting PA guidelines (OR = 0.61, 95% CI 36–1.05).


Close to 60% of African American breast cancer survivors did not meet PA guidelines based on recreational PA participation. Household PA was an important source of PA. Comorbidities and obesity were associated with both reduced total PA and not meeting PA guidelines.

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Fig. 1

Data Availability

The data used for this research study are not available to external researchers at this time.

Code Availability

Available upon request.



African American Breast Cancer Long-Term Survivorship Study


American Cancer Society


Body mass index


Confidence interval


Estrogen receptor status


Institutional Review Boards


Myocardial infarction


Odds ratio


Physical activity


Progesterone receptor status


Selective-estrogen receptor modulators




Tumor node metastasis


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We thank participants of the AABL Survivorship Study. We thank Mary Kay Fadden for her guidance and help with the data collection and questionnaire methods. We thank Shantel Moore for collecting all telephone interview data and day-to-day recruitment and coordination of the AABL study.


The original parent case-only study was funded by National Cancer Institute grants U54CA163069, U54CA163072, and R03CA192214. Allison D. Banks was supported by U54CA163069. The AABL study was supported by grant K07CA184257 from the National Cancer Institute.

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Sarah Nechuta, Katherine Busen, and Maureen Sanderson contributed to the study conception and design for this secondary data analysis. The analysis was performed by Katherine Busen and Sarah Nechuta. The first draft of the manuscript was written by Katherine Busen, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Sarah Nechuta.

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Institutional Review Board (IRB) approval for the AABL study was obtained from Vanderbilt University Medical Center and Meharry Medical College, and all study participants provided written informed consent.

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Busen, K., Sanderson, M., Banks, A.D. et al. Patterns of Physical Activity and the Role of Obesity and Comorbidities Among Long-term African American Breast Cancer Survivors. J. Racial and Ethnic Health Disparities (2022).

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  • Breast cancer
  • Cancer survivorship
  • Minority health
  • Physical activity
  • African American