ImportanceThe American Cancer Society’s (ACS’s) nutrition and physical activity guidelines are intended to reduce morbidity and mortality among cancer survivors, but to our knowledge, adherence to these guidelines has not been systematically quantified.ObjectiveTo evaluate adherence to and factors associated with adherence to lifestyle modification guidelines among cancer survivors.Design, Setting, and ParticipantsThis cross-sectional study used data from the Behavioral Risk Factor Surveillance System using survey administration years 2017 (surveys completed between January 2017 and March 2018), 2019 (surveys completed between January 2019 and December 2019), and 2021 (surveys completed between January 2021 and February 2022). The study included people who had completed cancer treatment at any point prior to the given survey administration year. Data were analyzed from September 19, 2022, to December 12, 2022.Main Outcomes and MeasuresThe primary outcome was adherence to current ACS guidelines for physical activity, body mass index, alcohol use, and fruit and vegetable intake. Factors associated with adherence rates to the guidelines, including age, sex, race and ethnicity, location, and educational level, were evaluated using linear regression. Complex survey weights were used.ResultsA total of 10 020 respondents (57% female; mean [SE] age, 64.2 [0.3] years) reported completion of cancer treatment, representing 2.7 million US individuals over 3 years. Of these respondents, 9121 completed questionnaires for all 4 metrics measured. A total of 72% (95% CI, 71%-74%) of cancer survivors met criteria for adequate physical activity, 68% (95% CI, 66%-69%) did not have obesity, 12% (95% CI, 11%-13%) ate adequate fruits and vegetables, and 50% (95% CI, 49%-52%) did not drink alcohol. In total, 4% (95% CI, 3%-4%) of cancer survivors adhered to all 4 guidelines, with the mean number of guidelines met being 2.0 (95% CI, 2.0-2.1). Factors associated with greater adherence included female sex, older age, Black race, higher educational level, and residence in Western US states.Conclusions and RelevanceIn this cross-sectional study, 4% of cancer survivors fully adhered to current ACS recommendations. Improved understanding of guideline adherence and its determinants may guide oncologists and general internists in providing recommendations for their patients who have completed cancer treatments.

中文翻译：

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癌症幸存者遵守美国癌症协会营养和身体活动指南

重要性美国癌症协会 (ACS) 的营养和身体活动指南旨在降低癌症幸存者的发病率和死亡率，但据我们所知，对这些指南的遵守情况尚未得到系统量化。 目的评估对生活方式改变的坚持以及与坚持相关的因素设计、设置和参与者这项横断面研究使用了行为风险因素监测系统的数据，使用 2017 年调查管理年（2017 年 1 月至 2018 年 3 月期间完成的调查）、2019 年（2019 年 1 月至 2019 年 12 月期间完成的调查） ）和 2021 年（2021 年 1 月至 2022 年 2 月期间完成的调查）。该研究包括在给定调查实施年份之前任何时间完成癌症治疗的人。数据分析时间为 2022 年 9 月 19 日至 2022 年 12 月 12 日。 主要结果和措施主要结果是遵守现行 ACS 体力活动、体重指数、饮酒以及水果和蔬菜摄入量指南。使用线性回归评估与指南遵守率相关的因素，包括年龄、性别、种族和民族、地点和教育水平。使用了复杂的调查权重。结果共有 10 020 名受访者（57% 为女性；平均 [SE] 年龄为 64.2 [0.3] 岁）报告完成了癌症治疗，代表 270 万美国人在 3 年内完成了癌症治疗。在这些受访者中，9121 人完成了所有 4 个衡量指标的调查问卷。总共 72%（95% CI，71%-74%）的癌症幸存者符合足够体力活动的标准，68%（95% CI，66%-69%）没有肥胖，12%（95% CI ，11%-13%）吃了足够的水果和蔬菜，50%（95% CI，49%-52%）不喝酒。总共有 4% (95% CI, 3%-4%) 的癌症幸存者遵守所有 4 条指南，符合的指南平均数量为 2.0 (95% CI, 2.0-2.1)。与较高依从性相关的因素包括女性、年龄较大、黑人种族、较高的教育水平和居住在美国西部各州。结论和相关性在这项横断面研究中，4% 的癌症幸存者完全遵守当前的 ACS 建议。提高对指南依从性及其决定因素的理解可以指导肿瘤学家和普通内科医生为已完成癌症治疗的患者提供建议。