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PERFORMANCE LIMITATIONS AND PARTICIPATION RESTRICTIONS AMONG CANCER SURVIVORS: A POPULATION-BASED STUDY FROM NHANES 2015-2018

Abstract

S.A. Myers1, E. Finch2, K.K. Ness2, K.L. Campbell, FACSM1

1University of British Columbia, Vancouver, BC

2St. Jude Children’s Research Hospital, Memphis, TN

Anti-cancer therapies have improved prognosis and survival outcomes in cancer survivors; however, therapy related toxicities may impact organ structure and function and interfere with physical performance and participation in life roles. PURPOSE: The aim of this analysis was to estimate the prevalence of physical performance limitations and participation restrictions among recent (<5 years since diagnosis), and long-term (≥5 years) cancer survivors. METHODS: Data from the 2015-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed using multivariable logistic regression, accounting for age, sex, race, and income, and incorporating survey sampling methodology. Odds ratios compared proportions of physical performance limitations and participation restrictions among 663 (weighted population estimate 14,319,219) recent and 341 (weighted population estimate 7,261,088) long-term survivors, and 10,284 (weighted population estimate 215,042,155) persons with no reported cancer history. Two sided two sample z-tests were used to compare proportions to a previous publication of data from 1999-2002 NHANES data. RESULTS:Physical performance limitations were 1.5-1.7 times (63% vs 29%) and participation restrictions 1.5-1.6 times (38% vs 18%) more prevalent in cancer survivors than in those with no cancer history. Recent cancer diagnosis was associated with increased prevalence of physical performance limitations and participation restrictions, particularly in difficulty stooping, crouching, kneeling (50.1%), difficulty standing for two hours (45.5%), and any limitation in physical performance (62.5%) compared to those with no cancer history (21.4%, 19.7%, and 29% respectively). Proportions increased by 8% for performance limitations and by 10% for participation restrictions compared to 1999-2002 values (p-values <0.001). CONCLUSION: Over 60% of cancer survivors reported physical performance limitations and nearly 40% reported participation restrictions. Despite an interim increase in evidence of the benefits of exercise to manage therapy related toxicities, these values are a significant increase when compared to data published using 1999-2002 NHANES data. Targeted exercise intervention aimed to improve physical function and performance in early cancer survivors should be considered to address the physical sequelae from anti-cancer therapies.

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