Beyond demographics: physical activity as a key behavioral marker for identifying the guidance-seeking profile to guide precision survivorship care.

OBJECTIVES: Variable-centered approaches often overlook the heterogeneity of unmet supportive care needs among breast cancer survivors. This study aimed to identify distinct latent profiles of survivors and examine whether physical activity is associated with these unmet-needs profiles, thereby providing supplementary information for supportive care assessment, moving beyond traditional sociodemographic factors.

METHODS: A cross-sectional study design was utilized. Unmet needs were assessed using the Chinese version of the Cancer Survivor Profile-Breast Cancer (CSPro-BC), while physical activity was measured via the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Latent Profile Analysis (LPA) was employed to classify survivor profiles, and multinomial logistic regression was conducted to identify associated factors.

RESULTS: Based on the baseline data of 630 Chinese breast cancer survivors, three distinct profiles were identified: "High-Need Symptom-Financial Dominant" (45.9%), "Low-Need Well-Adapted" (42.2%), and a novel "High-Need Guidance-Seeking Dominant" group (11.9%). While most traditional sociodemographic characteristics largely failed to distinguish these groups, higher education and high-level physical activity emerged as factors significantly associated with the "High-Need Guidance-Seeking Dominant" group. This subgroup represents a cohort where relatively high physical activity coexists with substantial unmet needs, a pattern that may be overlooked by conventional demographic risk assessments. Notably, despite exhibiting the highest levels of physical activity, their QoL scores were not significantly different from the "High-Need Symptom-Financial Dominant" group, highlighting a mismatch between high physical activity and QoL in this subgroup.

CONCLUSION: Current standardized screening protocols may overlook the "High-Need Guidance-Seeking Dominant" profile. These findings suggest that high-activity survivors with high unmet needs may benefit from further supportive-care assessment, and that higher physical activity does not necessarily indicate lower supportive-care needs. Whether tailored guidance offers advantages over generic advice, and whether incorporating physical activity assessments into routine screening can add incremental predictive value for supportive-care assessment and personalized support remains a hypothesis requiring prospective validation.