# 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.

## Key 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.