Persistent differences in aerobic physical activity guideline adherence among U.S. cancer survivors: Evidence from the national health interview survey, 2010-2020.

PURPOSE: This study examined national trends in adherence to aerobic physical activity (PA) guidelines and identified demographic, socioeconomic, behavioral, and health-related factors associated with aerobic PA adherence among adult cancer survivors in the United States. METHODS: A repeated cross-sectional analysis was conducted using data from the National Health Interview Survey (NHIS) 2010, 2015, and 2020 cycles. The analytic sample included 9,752 adult cancer survivors. Adherence to aerobic PA guidelines was defined as engaging in ≥ 150 min/week of moderate-intensity activity, ≥ 75 min/week of vigorous-intensity activity, or an equivalent combination. Survey-weighted descriptive analyses and multivariable logistic regression models were conducted to estimate prevalence and adjusted odds ratios (aORs) with 95% confidence intervals (CIs). RESULTS: Adherence to aerobic PA guidelines increased from 9.2% (95% CI, 7.8-10.8) in 2010 to 22.0% (95% CI, 20.0-24.2) in 2015 before declining to 8.7% (95% CI, 7.7-9.8) in 2020. Younger age, higher educational attainment, and higher household income were associated with greater odds of adherence. Functional limitations were strongly associated with lower adherence, particularly in 2020. Current smoking was negatively associated with adherence. CONCLUSIONS: Aerobic PA adherence among U.S. cancer survivors remained consistently low and varied substantially across survey years. Persistent socioeconomic and health-related disparities highlight the need for targeted survivorship interventions to improve aerobic PA participation. IMPLICATIONS FOR CANCER SURVIVORS: Accessible and tailored PA interventions may help reduce barriers to PA participation and improve long-term survivorship outcomes, particularly among survivors with functional limitations and socioeconomic disadvantages.