LAUSR

PURPOSE Cancer-related worry (concerns related to cancer and its late effects) (CRW) is prevalent among childhood cancer survivors. Elevated cancer-related worry has been associated with self-reported suboptimal physical activity. The aim of this investigation was to describe associations between cancer-related worry and objectively assessed physical activity in childhood cancer survivors. METHODS CRW was assessed at a baseline evaluation using six survey items. Weekly minutes of moderate and vigorous physical activity were captured by actigraphy 5.25-years (3.8-8.0) later. Factor analysis was used to identify types of worry; multiple regression determined independent associations between cancer-related worry and moderate and vigorous physical activity adjusting for sex, race, diagnosis, age at baseline, anxiety level at baseline, self-reported physical activity at baseline, and pain interference at baseline. RESULTS Participants (n = 1,223) were an average of 30.9-years (SD = 6.9) at baseline and 36.1-years (SD = 7.1) at follow-up. Thirty-seven percent (37%) were survivors of leukemia, 26% of non-central nervous system solid tumors, 19% of lymphoma, 11% of central nervous system tumors, and 6% of other malignancies. Two types of cancer-related worry were identified: "Body-Focused" and "General Fear". "Body-Focused" CRW (β = -19.6, p = 0.012), endorsing pain interference (β = -27.7, p = 0.002) at baseline and having a diagnosis of CNS tumor (β = -41.3, p = 0.0003) or non-CNS solid tumor (β = -19.4, p = 0.02) were negatively associated with physical activity at follow-up. CONCLUSIONS Cancer-related worry related to bodily function and appearance is associated with decreased physical activity. Clinicians should consider the potential negative impact of cancer-related worry on physical activity levels and provide behavioral counseling.