Veteran Satisfaction With Lung Cancer Screening Care: A Cross-Sectional Evaluation.

Cancer is a leading cause of mortality globally [, ]. In 2022, there were an estimated 20 million new cancer diagnoses and 9.7 million deaths attributed to cancer []. Recent consensus statements on cancer prevention have focussed on lifestyle behaviours, finding physical inactivity among the most modifiable of risk factors and a target for intervention []. Regular engagement in leisure-time physical activity (LTPA) has been previously associated with an 8–25% reduction in cancer risk across a wide range of cancer sites including upper gastrointestinal and liver cancers, and even highly prevalent cancers, including lung, breast and colorectal cancers [, ]. Nevertheless, physical activity (PA) is only one facet of the 24-hour (h) daily movement spectrum, alongside sleep and sedentary behaviour (SB) [], and also encompasses a spectrum of postures and movement intensities. Given the finite nature of time use, it is crucial for public health guidance to understand which behaviours should be a focus of behaviour change interventions for cancer risk reduction. Studies have also reported an adverse relationship between SB, and cancer, independent of PA [–], while the literature focusing on sleep is largely inconclusive []. Despite these independent lines of evidence, the field has increasingly acknowledged the interplay between all daily movement behaviours, including SB and sleep for health and longevity [–]. The World Health Organization (WHO) recommends 150–300 min of moderate-intensity PA, or 75 min of vigorous-intensity PA, weekly [, ]. There is however. a growing interest in 24-h guidelines for movement behaviour, which encompass PA, SB and sleep, each of which have health consequences, and therefore multiple possible behaviour change options may yield health benefits [, ]. The 24-h movement continuum may be characterised according to both posture and movement intensity, and can be studied through 24-h accelerometery [–]. When combined with compositional data analysis, which can model all movement in the 24-h day simultaneously, while focusing on the sample average day, it is possible to estimate the difference in risk associated with even modest differences in average daily movement []. Despite their methodologic strengths, prior studies that have used a compositional approach typically examine only one dimension of movement behaviour (intensity), resulting in a narrow range of recommendations [, ]. Given the high-proportion of individuals globally who remain physically inactive [], and the need to accommodate for the needs of those for whom find it challenging to meet the intensity-based guidelines, we sought to explore multiple dimensions of movement behaviour. Each of these dimensions (e.g. posture/intensity) may be clinically useful and adaptable to different circumstances. Accordingly, we adopted a dual-approach; separately modelling two compositions of movement behaviour, sedentary time and sleep in relation to cancer risk.