Physical Activity And Perceptions Of Body Image Among Patients Diagnosed With Early-Onset Cancers

Body image may significantly impact the mental health of cancer survivors, especially adults diagnosed before age 50 years (early-onset; EO). However, the relationship between body image and physical activity (PA) remains unclear. PURPOSE: To identify associations between self-reported leisure-time PA and perceived body image specific to patients with EO cancers. METHODS: The Reproductive Health After Cancer Diagnosis and Treatment (REACT) Study is a patient-partnered study in cooperation with 23 community partners and multiple patient advocates. Adults with a first primary EO cancer were recruited over an 8-week period (October to December 2021). Patient-reported questions, including body image measured via the Stunkard Body Image Scale (current and ideal body image, body image at cancer diagnosis), PA and body composition, were prospectively collected via survey using a secure, web-based application. Associations between body image and PA were quantified using Spearman partial correlation coefficients adjusted for key confounders (e.g. age at EO diagnosis). RESULTS: Among 313 patients with complete PA, body image and composition data who were diagnosed with an EO cancer between 2016 and 2021 (mean [SD] age, 36.9 [7.6] years), 76.4% were female sex at birth. Half of the cohort was overweight at EO cancer diagnosis (mean body mass index [BMI], 28.0 ± 7.4 kg/m2). Participants were relatively active, accruing 179.0 ± 213.8 leisure-time PA minutes/week and with 50.8% meeting PA guidelines. Current BMI strongly correlated with current body image (R2 = 0.83, p < 0.001). BMI and body image at cancer diagnosis were also strongly correlated (R2 = 0.82, p < 0.001). Significant inverse correlations were observed between leisure-time PA and body image at cancer diagnosis (R2 = -0.21, p = 0.0014), with current body image (R2 = -0.026, p < 0.001) and ideal body image (R2 = -0.25, p = 0.001) among female patients. In contrast, no significant correlations were observed among males (Body image at diagnosis: R2 = -0.05, p = 0.7; Current: R2 = -0.14, p = 0.2; Ideal: R2 = 0.05, p = 0.7). CONCLUSION: Moderate associations exist between PA and body image domains for female, but not male, patients with EO cancers. This may have wide-ranging impact on the relationship between PA and mental health specific to this growing patient population.