Accelerometry-derived latent class analysis and cancer in the Women's Health Accelerometry Collaboration

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Abstract Cancer is the second leading cause of death in the United States for women, with an estimated 289,150 cancer-related deaths and 927,910 new cancer cases predicted to occur among women in 2021. Considering the life span, almost 40% of women will be diagnosed with cancer at some point in their lifetime. Understanding amenable risk factors that contribute to this large public health burden is essential. Observational studies indicate associations between self-reported physical activity and increased risk of many types of cancer. However, there is insufficient evidence regarding the amount, intensity, duration, and types of physical activity required to reduce cancer risk, especially for older women. Sedentary behavior may provide a more feasible intervention target, especially for older adults. However, even less is known about sedentary behavior and cancer risk. Our original application (#1 R01CA227122) was funded to assemble accelerometry- assessed physical activity and sedentary behavior (collected from 2011-2014) and cancer incident events and deaths from two cohort studies of women: the Women’s Health Study and the Women’s Health Initiative Objective Physical Activity and Cardiovascular Health Study. Together, these two cohorts were harmonized and comprise the Women’s Health Accelerometry Collaboration. We are applying sophisticated methods to determine which physical activity and sedentary behavior features are most important for reducing cancer risk among more than 22,000 women 62 years and older. Follow-up of both cohorts for adjudicated cancer outcomes is ongoing. This current application will support an applicant through a National Institutes of Health diversity supplement and focus on applying latent class analysis to accelerometry. Specifically, a literature review on the use of latent class analysis or latent class trajectory modelling applied to accelerometry will be conducted. Using the knowledge gained from the review, latent class measures will be derived among the cohort from the Women’s Health Accelerometry Collaboration for both physical activity and sedentary behavior. Those classes will then be used to explore the associations of the latent classes with overall and site-specific (e.g., breast, lung) incident and fatal cancer. This project will seek to address whether certain patterns of physical activity and sedentary behavior put women at higher or lower risk for incidence of cancer. Identification of new cancer-protective patterns of physical activity and sedentary behavior will help inform physical activity and sedentary behavior guidelines for cancer prevention and can be used in interventions to reduce risk.