Leisure-time physical activity after diagnosis and survival by cancer type: a pooled analysis.

Abstract

PURPOSE Evidence for potential mortality benefits of leisure-time moderate-to-vigorous intensity physical activity (MVPA) for survivors of cancer types beyond breast and colorectal is limited. The aim of this study was to evaluate relationships between postdiagnosis MVPA and all-cause mortality in participants with a history of eleven cancer types. METHODS Data were pooled from six United States-based cohort studies. Cohort-specific hazard ratios and 95% confidence intervals (HR, CI) for associations of MVPA assessed ≥1-year after a cancer diagnosis and all-cause mortality were calculated using multivariable Cox proportional hazards models and then pooled using random effects meta-analysis. Models were adjusted for age, sex, race/ethnicity, smoking status, alcohol use, cancer treatment and stage. The sample included 90,844 cancer survivors (mean [standard deviation] age at diagnosis = 67 [10] years, 55% women), among whom 45,477 died during 10.9 [7.0] years of follow-up. RESULTS Compared to no MVPA, engaging in recommended amounts of MVPA (7.5-<15 MET-hr./wk.) was related to better overall survival in participants with a history of one of ten cancer types: oral (HR = 0.44, 0.27-0.73), endometrial (0.50, 0.34-0.76), lung (0.51, 0.38-0.68), rectal (0.51, 0.36-0.71), respiratory (0.51, 0.29-0.72), bladder (0.53, 0.40-0.72), kidney (0.53, 0.37-0.77), prostate (0.60, 0.49-0.74), colon (0.61, 0.50-0.76), and breast (0.67, 0.55-0.81). Eight of the ten observed inverse associations remained similar when excluding participants who died within two years of follow-up. CONCLUSION Engaging in leisure-time MVPA after a cancer diagnosis appears to improve survival for people with a history of several cancer types, including bladder, breast, colon, endometrial, kidney, lung, oral, prostate, rectal, and respiratory cancer.