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Physical activity, Cancer survivors, Medical expenditure, The Medical Expenditure Panel Survey, National Health Interview Survey


Multiple chronic conditions in cancer survivors are highly prevalent and may increase health care costs for both patients and the health care system. Studies of cancer survivors reveal positive effects of physical activity (PA) on reducing risk of cancer recurrence, other chronic conditions, and secondary cancer. Few nationally representative studies have examined how physical activity levels have affected survivors' annual economic burden in the United States.

Leisure-time physical activity data from the National Health Interview Survey was linked to health care expenditure data from the Medical Expenditure Panel Survey data (2008–2012). We calculated per-person annual total medical expenditures for identified colorectal, breast, and prostate cancer survivors. We conducted multivariable analyses controlled for survival years and other sociodemographic variables. Generalized linear models were performed to measure correlation between medical expenditure and PA level using STATA 14. All analyses considered the complex survey design and were conducted in 2017.

Of 1015 cancer survivors sampled, 30% (n=305) adhered to physical activity recommendation, while the other 70% (n=710) did not. Multivariable-adjusted expenditure in adherence group was $9108.8 (95% CI 7410.9–10,806.7) versus 12,899.1 (95% CI 11,450.2–14,348) in non-adherence group. Stratified analyses revealed cancer survivors who adhered to their PA recommendation saved $4686.1 (1–5 years' survival time) and $2874.5 (11 or more years' survival time) on average for total health care expenditure, respectively.

Analyses of the national representative sample revealed that the economic burden of survivors from the three most prevalent cancers is substantial. Increasing survivor's PA to guidelines may reduce U.S. health care expenditure.