Leisure-time physical activity among US cancer survivors, 2020-2024.

10623 Background: Physical activity (PA) after a cancer diagnosis reduces treatment-related side effects and improves quality of life and cancer outcomes. Historical data show that most cancer survivors do not meet recommended levels of aerobic and strength training PA. However, the recent pattern of PA in people with cancer remained unexamined. Methods: This pooled cross-sectional study analyzed data from the 2020, 2022, and 2024 National Health Interview Survey to examine the prevalence and predictors of meeting PA guidelines among US cancer survivors vs. non-cancer adults. The analytic sample included adults aged ≥18 years with available cancer history. Data were collected on frequency and duration of aerobic and strength training PA. Age-adjusted prevalence of meeting aerobic (≥150 minutes per week of moderate-intensity activity or ≥75 minutes per week of vigorous-intensity activity) and strength training (≥2 days per week) PA guidelines were estimated across sociodemographic and health characteristics among cancer survivors and non-cancer adults. Multivariable logistic regression models were fitted to identify factors associated with meeting PA guidelines among cancer survivors. Results: The final sample included 8,974 cancer survivors (Mean age: 65.7 [SE: 0.21]; 57.3% female) and 79,036 non-cancer adults (Mean age: 46.6 [SE: 0.11]; 51.1% female). After age-adjustment, 44.5% of cancer survivors met guidelines for aerobic exercise (95% CI: 41.8-47.3), 28.9% for strength training (26.3-31.6), and 22.2% for both (19.8-24.7%), significantly lower than the non-cancer group (48.3%, 32.5%, and 26.0%; all p <0.01). Patterns of lower prevalence were consistent across aerobic, strength training, and combined guidelines. Among cancer survivors, age-adjusted prevalence of meeting PA guidelines was significantly lower among those who were female, non-Hispanic Black or Hispanic, had lower levels of education or income, lived alone, were unemployed, had BMI ≥ 25, or were current smokers (all p<0.05). Survivors of gynecological and lung cancers had significantly lower age-adjusted prevalence of meeting both aerobic and strength training guidelines, while gastrointestinal cancer survivors had lower prevalence of meeting strength training guidelines only (all p<0.01). After adjustment for all covariates, not meeting PA guidelines in cancer survivors remained significantly associated with older age, female, lower education level, BMI ≥ 25, current smoking, and presence of cardiovascular disease or diabetes (all p<0.05). Conclusions: During 2020 and 2024, fewer than 1 in 4 cancer survivors met both aerobic and strength training PA guidelines. These findings underscore a critical need to integrate PA interventions into standard oncology survivorship care, with particular attention to addressing socioeconomic barriers and tailoring programs for survivors with comorbidities and high-risk cancer types.