Racial and Ethnic Disparities in Diet-Related Cancer Risk Awareness and Behaviors Among Cancer Survivors: An Analysis of the Health Information National Trends Survey (HINTS)

Abstract

Healthy dietary behaviors are associated with improved survival and quality of life among cancer survivors. Worse cancer survival was reported in racial minorities, but whether diet-related cancer risk awareness and behaviors are different in racial and ethnic groups remains unexplored. We initiated a pooling study using the Health Information National Trends Survey (HINTS) to study the disparities of diet-related awareness and behaviors among cancer survivors. The study is a pooled, weighted analysis of eight cross-sectional surveys from HINTS. We harmonized variables to represent diet-related awareness and behaviors. In total, 6094 cancer survivors were included from HINTS 1, HINTS 4, HINTS 5 and HINTS 6 iterations. Chi-square test and logistic regression models were used to identify racial disparities. The results showed racial/ethnic disparities in both diet-related cancer risk awareness and dietary behaviors among cancer survivors. While all groups exhibited low adherence to dietary guidelines, racial minority groups showed slightly better awareness of how processed meat (OR = 0.29, 95% CI = 0.10, 0.85), red meat (OR = 0.47, 95% CI = 0.25, 0.89), and sugar-sweetened beverages (OR = 0.43, 95% CI = 0.23, 0.82) influence cancer risk compared to the non-Hispanic White (NHW) survivors. However, these awareness levels did not consistently translate into healthy dietary behaviors. NHB survivors reported significantly higher consumption of sugar-sweetened beverages (SSB) (OR = 2.70, 95% CI = 1.17, 6.24), and non-Hispanic other group (NHO) were less likely to use calorie information on restaurant menus (OR = 2.45, 95% CI = 1.07, 5.62). Our research findings highlight the need for culturally adaptive interventions, emphasizing education and a comprehensive, practical approach to translate dietary guidelines into real-world applications.

Keywords: Cancer survivors; Diet awareness; Dietary behavior; Ethnic and racial minorities; HINTS survey; Minority groups; Racial disparity; Survey.