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Principal Investigator: Jean-Philippe Laurenceau
Organization: UNIVERSITY OF DELAWARE
Fiscal Year: 2024
Award: $611,003
Funding agency: National Cancer Institute
Project Summary/Abstract
Breast cancer (BC) is the most commonly diagnosed cancer and the second leading cause of
cancer mortality among women in the US (ACS, 2017). High baseline prevalence, increasing
screening rates, and better treatments have all contributed to a large population of BC survivors
that will increase from an estimated 3.5 million in 2016 to a projected 4.5 million in the next 10
years (ACS, 2017). Multiple studies document fear of cancer recurrence (FCR) as a top long-
term concern of both cancer survivors and their significant others that impacts on quality of life.
Despite an increasing emphasis on FCR in the literature, a critical gap in knowledge is how FCR
can produce health behavior consequences with known implications for long-term health
outcomes. The overall objective of this proposal is to examine medication adherence, physical
activity/sedentary behavior, and sleep as three proximal health behavior outcomes that are
modifiable and have been linked to recurrence (for patients) as well as morbidity and mortality
(for both patients and spouses/partners). Moreover, FCR and health behaviors are concordant
within-couple reflecting an interdependent and interpersonal context that, if ignored, would limit
a complete understanding of important health consequences of FCR. Preliminary data from a
recently completed NCI-funded R21 project form the scientific premise and the basis of power
analyses for the specific and exploratory aims. Using longitudinal, within-person methods as
well as individual and dyadic multilevel structural equation modeling, we will pursue the
following hypothesis-driven aims: 1) identify the consequences of FCR for physical activity; 2)
identify the consequences of FCR for adherence to adjuvant hormonal treatment; and 3) identify
the consequences of FCR for sleep quantity and quality. Finally, using biomarkers of cardio-
metabolic health risk (i.e., HbA1c, lipids, insulin resistance, body composition), we will explore
the links between the targeted health behaviors and these health outcomes. A long-term
objective of the proposed work is to influence the development and refinement of interventions
for FCR and health behaviors ultimately increasing optimal mental and physical well-being of
cancer survivors and their spouses/partners.
Terms: <Adherence><Adjuvant><Adjuvant Therapy><Biological Markers><Body Composition><Breast Cancer><Breast Cancer survivor><Cancer Cause><Cancer Etiology><Cancer Survivor><Cancer Treatment><Cancers><Cardiovascular Diseases><Cross Sectional Analysis><Cross-Sectional Analyses><Cross-Sectional Studies><Cross-Sectional Survey><Data><Development><Diagnosis><Disease Frequency Surveys><Equation><Fasting><Fear><Fright><Funding><Glycohemoglobin A><Glycosylated hemoglobin A><Goals><Hb A1><Hb A1a+b><Hb A1c><HbA1><HbA1c><Health><Health behavior><Health behavior and outcomes><Hemoglobin A(1)><Hormonal><Individual><Insulin Resistance><Investigation><Knowledge><Link><Lipids><Literature><Malignant Breast Neoplasm><Malignant Neoplasm Therapy><Malignant Neoplasm Treatment><Malignant Neoplasms><Malignant Tumor><Married Persons><Measures><Metabolic Diseases><Metabolic Disorder><Methods><Modeling><Monitor><Morbidity><Morbidity - disease rate><Outcome><Parameter Estimation><Patient Self-Report><Patients><Personal Satisfaction><Persons><Physical activity><Population><Prevalence><Psyche structure><Psychosocial Effect><Public Health><Publishing><QOL><Quality of life><Recommendation><Recurrence><Recurrent><Recurrent Malignant Neoplasm><Recurrent Malignant Tumor><Reporting><Research><Risk><Sedentary behavior><Sedentary life-style><Self-Report><Sleep><Sleep disturbances><Spouses><Strenuous Exercise><Thesaurismosis><Time><Treatment/Psychosocial Effects><Weight Gain><Weight Increase><Women's mortality><Work><aberrant sleep><adjuvant treatment><anti-cancer therapy><bio-markers><biologic marker><biomarker><body weight gain><body weight increase><cancer diagnosis><cancer recurrence><cancer therapy><cancer-directed therapy><cardiometabolic><cardiometabolism><cardiovascular disorder><death among females><death among women><death in females><death in women><death rate among women><death rate in women><developmental><diaries><disrupted sleep><disturbed sleep><drug adherence><drug compliance><fasted><fasts><female death><female mortality><health related behavior><hemoglobin A1c><impaired sleep><improve symptom><improved><indexing><innovate><innovation><innovative><insulin resistant><insulin tolerance><intense exercise><intervention refinement><irregular sleep><malignancy><malignant breast tumor><manage symptom><medication adherence><medication compliance><mental><metabolism disorder><mortality><mortality among females><mortality among women><mortality in females><mortality in women><neoplasm/cancer><power analysis><quality of sleep><screening><screenings><sedentary lifestyle><sleep disruption><sleep dysregulation><sleep quality><sleep quantity><strenuous activity><strenuous physical activity><symptom improvement><symptom management><symptomatic improvement><treatment adherence><treatment compliance><vigorous exercise><vigorous physical activity><well-being><wellbeing><women's death><women's death rate><wt gain>