Changes in Physical Activity and Mortality Risk among Korean Cancer Survivors: A Population-Based Cohort Study.

IF 3.4 3区 医学 Q2 ONCOLOGY
Thi Tra Bui, Eunjung Park, Hee-Yeon Kang, Byungmi Kim, Jin-Kyoung Oh
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引用次数: 0

Abstract

Background: The impact of changes in physical activity (PA) after cancer diagnosis on prognosis remains unclear. This study evaluated mortality risks according to changes in PA from prior to diagnosis to after diagnosis among cancer survivors.

Methods: This population-based retrospective cohort study used the Korean National Health Insurance Service database. The study included 215,191 participants (125,756 men and 89,435 women) diagnosed with cancer between 2009 and 2017. PA, measured as the total of various light-, moderate-, and vigorous-intensity activities, was assessed prior to and after diagnosis. Deaths were ascertained between 2009 and 2019. All-cause and cancer-specific mortality risks were assessed according to PA changes using Cox proportional hazards regression.

Results: Following cancer diagnosis, active patients accounted for 63.30% of men and 55.29% of women, increasing from 54.04% and 43.35% prior to diagnosis. Compared with the consistently inactive group, all-cause mortality risks were significantly lower in patients who became active after diagnosis [adjusted HR (95% confidence intervals): men, 0.82 (0.79, 0.85); women, 0.87 (0.82, 0.93)] and in the consistently active group [men, 0.77 (0.74, 0.80); women, 0.81 (0.76, 0.86)]. Lower mortality risks were observed across cancer stages in men and localized/regional stages in women. PA and all-cause mortality had a dose-response association. PA was inversely associated with all-cause or cancer-specific mortality in men with gastric, colorectal, liver, and lung cancers and women with colorectal cancer.

Conclusions: Being physically active after diagnosis is associated with reduced all-cause mortality among cancer survivors in a dose-response manner, regardless of PA levels prior to diagnosis.

Impact: PA should be promoted as a standard component of cancer care to improve prognosis.

韩国癌症幸存者的身体活动变化和死亡风险:一项基于人群的队列研究
癌症诊断后身体活动(PA)变化对预后的影响尚不清楚。本研究根据癌症幸存者从诊断前到诊断后PA的变化来评估死亡风险。方法本研究采用韩国国民健康保险服务数据库,以人群为基础进行回顾性队列研究。该研究包括215,191名参与者(125,756名男性和89,435名女性)在2009年至2017年期间被诊断患有癌症。PA测量为各种轻度、中度和剧烈活动的总和,在诊断前和诊断后进行评估。死亡人数在2009-2019年期间确定。采用Cox比例风险回归,根据PA变化评估全因和癌症特异性死亡风险。结果癌后诊断活跃患者中男性占63.30%,女性占55.29%,高于诊断前的54.04%和43.35%。与一贯不运动组相比,诊断后开始运动的患者的全因死亡风险显著降低(校正风险比[95%置信区间]:男性,0.82 [0.79,0.85];女性,0.87[0.82,0.93])和持续运动组(男性,0.77 [0.74,0.80];女性,0.81[0.76,0.86])。在男性癌症分期和女性局部/区域分期中观察到较低的死亡风险。PA与全因死亡率呈剂量-反应相关性。在男性胃癌、结直肠癌、肝癌和肺癌患者以及女性结直肠癌患者中,PA与全因或癌症特异性死亡率呈负相关。结论:无论诊断前PA水平如何,在癌症幸存者中,诊断后进行体力活动与降低全因死亡率以剂量反应方式相关。影响:PA应作为癌症治疗的标准组成部分加以推广,以改善预后。
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来源期刊
Cancer Epidemiology Biomarkers & Prevention
Cancer Epidemiology Biomarkers & Prevention 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
2.60%
发文量
538
审稿时长
1.6 months
期刊介绍: Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.
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