Healthy Habit Adherence in Uruguayan Women Under Breast Cancer Follow-Up

TL;DR

Uruguayan breast cancer patients mostly follow healthy habits like avoiding smoking and alcohol, but need to improve physical activity and fruit/vegetable intake, especially in public healthcare settings.

Contribution

First study to assess healthy habit adherence in Uruguayan women with breast cancer, highlighting disparities between public and private healthcare sectors.

Findings

80.8% of patients adhered to three or more healthy habits, with non-smoking and low alcohol intake being most common.

Patients in private healthcare centers showed significantly higher adherence to healthy habits compared to those in public centers.

Physical activity and fruit/vegetable intake were the least adhered to, indicating key areas for intervention.

Abstract

Introduction: Breast cancer (BC) ranks first in incidence and mortality among Uruguayan women. Healthy habits (HHs) - maintaining a healthy weight, engaging in regular physical activity, consuming fruits and vegetables (F&V), avoiding smoking, and limiting alcohol intake - are associated with better quality of life and reduced risk of recurrence. However, there is limited information on the prevalence of HH among Uruguayan women with BC.

Methods: This observational, descriptive, multicenter study included patients with stage I-III BC from public and private healthcare centers in Uruguay. Adherence to HH was assessed using a questionnaire based on the American Cancer Society guidelines, evaluating diet, physical activity, alcohol, and tobacco use. Patients were classified into low (0-2), moderate (3), and high adherence (4-5) groups. Associations with specific variables such as healthcare setting (private vs. public), age, cancer stage, and time since diagnosis were analyzed using the Chi-squared test.

Results: A total of 209 patients were included. Overall, 80.8% (169 patients) adhered to three or more HH. Higher adherence was observed among patients attending private centers (89.6%, 69 patients) compared to public ones (75.7%, 100 patients; p=0.014). The most commonly met habits were non-smoking (88.9%; 95% CI: 84.0%-92.6%), low alcohol intake (99.0%; 95% CI: 96.6%-99.7%), and body mass index (BMI) <30 kg/m² (68.9%; 95% CI: 62.3%-74.8%). Lower adherence was seen for sufficient physical activity (55.5%; 95% CI: 48.7%-62.1%) and adequate F&V intake (31.6%; 95% CI: 25.7%-38.2%). No significant differences were found in adherence according to age, stage, or time since diagnosis.

Conclusion: Although 80.8% of patients adhered to at least three HHs, critical areas for improvement remain, particularly physical activity and F&V consumption, especially in the public sector. These findings highlight the need for targeted strategies to promote HH in BC patients to improve long-term outcomes and quality of life. Results should be interpreted with caution due to the use of self-reported questionnaires and the non-probabilistic nature of the sample.