A growing body of evidence has shown an increased risk of developing and dying from cancer that is linked to obesity and associated factors. An online survey of patients with cancer designed to evaluate their understanding of obtaining weight, diet, and exercise recommendations and referrals as a component of their care was conducted by the American Society of Clinical Oncology (ASCO). Between March and June 2020, this assessment was delivered to prospective participants using both patient advocacy organizations and ASCO channels, reaching more than 25,000 individuals. Patients were eligible to participate if they had been diagnosed with cancer, were at least 18 years of age, and lived in the United States.
Patterns of referral and recommendations were ascertained using logistic regression analysis. A total of 2419 individuals responded to the survey. More than three-quarters (75.5%) of survey respondents were female, more than one-third (38.2%) had advanced disease, and nearly half (49.0%) were currently receiving treatment. The survey revealed that the most common type of cancer impacting the patients was breast cancer (36.0%), and the respondents’ average body mass index was classified as “overweight,” at 25.8 kg/m2. More than 50% of participants consumed 2 servings of fruits and vegetables daily and exercised twice per week. At some or most oncology visits, 57.5% of respondents reported that exercise was addressed by their oncology care team, more than half (50.7%) addressed diet, and 28.4% reported weight was addressed. In comparison, referrals to exercise programs were less common, with only 14.9% of respondents stating this occurred. More than one-quarter (25.6%) of patients were referred to a nutritionist, and only 4.5% were referred to a weight management program.
Racial and ethnic minority respondents were more likely to receive advice than non-Hispanic whites about diet and weight. Patients who had been diagnosed with cancer in the past 5 years were more likely to receive advice about exercise compared with patients who had received their diagnosis more than 5 years previously. Breast cancer patients were more likely to have received advice about exercise and weight than other patients with cancer. After having been diagnosed with cancer, survey respondents related that their diet or exercise changed in nearly three-quarters (74%) of cases. Oncologists who spoke to patients about increasing exercise or eating healthier foods had patients who were significantly more likely to report a change in behavior than oncologists who did not (exercise: 79.6% vs 69.0%, P <.001; diet: 81.1% vs 71.4%, P <.001).
If patients were spoken to about the benefits of exercise during oncology visits, they were significantly more likely to exercise >2 times per week compared with patients whose oncologists did not speak about the importance of exercise, at a rate of 53.5% compared with 44.1%. If healthcare providers recommended diet and exercise, there were additional positive changes seen in associated behavioral changes. To assist with healthy lifestyle changes for patients with cancer, further awareness is needed that diet and exercise should be consistently addressed as a routine part of oncology visits.
Ligibel JA, Pierce LJ, Bender CM, et al. Attention to diet, exercise, and weight in the oncology clinic: results of a national patient survey. Presented at: American Society of Clinical Oncology 2021 Annual Meeting, June 4-8. Abstract 10549.