The association of perceived health status and presence of chronic conditions with physical activity in childhood cancer survivors.

Purpose: Childhood cancer survivors (CCS) are at risk for therapy-related late effects. Physical activity (PA) can minimize some late effects risk, but rates of PA are low in CCS. We aimed to determine how perception of survivor health status and presence of chronic conditions are associated with patient- or proxy-reported PA.

Methods: This cross-sectional, retrospective study of CCS (6-25 years; ≥ 1 year off-therapy) defined low PA as < 5 days per week with ≥ 60 minutes/day of patient- or proxy-reported activity. Participants completed PROMIS Global Health questions assessing perceptions of overall, physical, and mental health. Presence of chronic conditions was abstracted from the health record and defined as ≥ 2 late effects. Multivariable logistic regressions were performed to identify associations between physical activity and health status or chronic conditions.

Results: Of 284 CCS, 71.8% reported low PA. Negative perceived overall, physical, and mental health status were present in 5.6%, 10.6%, and 15.9% of CCS, respectively, with presence of chronic conditions in 49.7%. Low PA was directly associated with female sex (p = 0.002) and poor physical (p = 0.01) and mental (p = 0.02) health status, and inversely associated with relapsed/refractory disease (p = 0.03). Presence of chronic conditions was not associated with low PA (p = 0.68); however, all CCS with chronic graft-versus-host disease or vision impairment had low PA.

Conclusion: Low PA is an issue for CCS, especially females, and is associated with negative perceived physical and mental health. Future PA interventions for CCS should address perceived physical and mental health, and focus on specific at-risk sub-groups.