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01-01-2019 | Original paper

Habitual recreational physical activity is associated with significantly improved survival in cancer patients: evidence from the Roswell Park Data Bank and BioRepository

Authors: Rikki A. Cannioto, Shruti Dighe, Martin C. Mahoney, Kirsten B. Moysich, Arindam Sen, Karen Hulme, Susan E. McCann, Christine B. Ambrosone

Published in: Cancer Causes & Control | Issue 1/2019

Abstract

Purpose

The association of recreational physical activity (RPA) with mortality is well established only for breast and colon cancers and few studies have evaluated relationships for exercising before and after diagnosis, across multiple disease sites. We examined the joint associations of pre- and post- diagnosis RPA with mortality in a cohort of 5,807 patients enrolled in the Data Bank and BioRepository at Roswell Park.

Methods

Patients were classified into one of four activity categories (habitually active, increased activity after diagnosis, decreased activity after diagnosis, habitually inactive). Cox proportional hazards models were used to estimate the associations of activity status with mortality.

Results

In comparison to patients who were habitually inactive, habitually active patients experienced a 39% decreased hazard of all-cause mortality (HR = 0.61, 95% CI 0.54–0.69) and a 36% decreased hazard of cancer-specific mortality (HR = 0.64, 95% CI 0.56–0.73). Previously inactive patients who began exercising after diagnosis experienced a 28% decreased hazard of all-cause (HR = 0.72, 95% CI 0.59–0.89) and cancer-specific mortality (HR = 0.72, 95% CI 0.57–0.91) in comparison to patients who remained inactive. Patients engaging in 3–4 sessions/week experienced the greatest survival advantages, but 1–2 sessions/week also yielded significant survival advantages in comparison to inactivity.

Conclusion

Low-to-moderate frequency pre- and post-diagnosis RPA was associated with significantly decreased mortality in patients diagnosed with a variety of malignancies. These observations solidify the clinical and public health importance of the message that some regular activity is better than inactivity, which is particularly encouraging, given that cancer survivors can be overwhelmed by current daily physical activity recommendations.

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NCI. Cancer Survivors, and Physical Activity: U.S. Department of Health and Human Services; 2018 [updated February 2018; cited 5 March 2018]. https://progressreport.cancer.gov/after/physical_activity

Li T, Wei S, Shi Y, Pang S, Qin Q, Yin J et al (2016) The dose-response effect of physical activity on cancer mortality: findings from 71 prospective cohort studies. British journal of sports medicine 50(6):339–345. https://doi.org/10.1136/bjsports-2015-094927 CrossRefPubMed

Schmid D, Leitzmann MF (2014) Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Ann Oncol 25(7):1293–1311CrossRef

Alfano CM, Klesges RC, Murray DM, Bowen DJ, McTiernan A, Vander Weg MW et al (2004) Physical activity in relation to all-site and lung cancer incidence and mortality in current and former smokers. Cancer Epidemiol Biomark Prev 13(12):2233–2241

Arem H, Moore SC, Park Y, Ballard-Barbash R, Hollenbeck A, Leitzmann M et al (2014) Physical activity and cancer-specific mortality in the NIH-AARP Diet and Health Study cohort. Int J Cancer 135(2):423–431CrossRef

Hastert TA, Beresford SA, Sheppard L, White E (2014) Adherence to the WCRF/AICR cancer prevention recommendations and cancer-specific mortality: results from the Vitamins and Lifestyle (VITAL) Study. Cancer Causes Control 25(5):541–542. https://doi.org/10.1007/s10552-014-0358-6 CrossRefPubMedPubMedCentral

Kampert JB, Blair SN, Barlow CE, Kohl HW 3rd (1996) Physical activity, physical fitness, and all-cause and cancer mortality: a prospective study of men and women. Ann Epidemiol 6(5):452–457CrossRef

Lee JY, Ryu S, Cheong E, Sung KC (2016) Association of physical activity and inflammation with all-cause, cardiovascular-related, and cancer-related mortality. Mayo Clin Proc 91(12):1706–1716CrossRef

McCullough ML, Patel AV, Kushi LH, Patel R, Willett WC, Doyle C et al (2011) Following cancer prevention guidelines reduces risk of cancer, cardiovascular disease, and all-cause mortality. Cancer Epidemiol Biomark Prev. 20(6):1089–1097. https://doi.org/10.1158/1055-9965.epi-10-1173 CrossRef

10.

O’Donovan G, Lee IM, Hamer M, Stamatakis E (2017) Association of “Weekend Warrior” and other leisure time physical activity patterns with risks for all-cause, cardiovascular disease, and cancer mortality. JAMA Intern Med 177(3):335–342. https://doi.org/10.1001/jamainternmed.2016.8014 CrossRefPubMed

11.

Parekh N, Lin Y, Craft LL, Vadiveloo M, Lu-Yao GL (2012) Longitudinal associations of leisure-time physical activity and cancer mortality in the Third National Health and Nutrition Examination Survey (1986–2006). J Obesity. https://doi.org/10.1155/2012/518358 CrossRef

12.

Maldonado G, Greenland S (1993) Simulation study of confounder-selection strategies. Am J Epidemiol 138(11):923–936CrossRef

13.

DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Controlled Clinical Trials 7(3):177–188CrossRef

14.

Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560CrossRef

15.

Borch KB, Braaten T, Lund E, Weiderpass E (2015) Physical activity before and after breast cancer diagnosis and survival—the Norwegian women and cancer cohort study. BMC Cancer 15:967. https://doi.org/10.1186/s12885-015-1971-9 CrossRefPubMedPubMedCentral

16.

Friedenreich CM, Wang Q, Neilson HK, Kopciuk KA, McGregor SE, Courneya KS (2016) Physical activity and survival after prostate cancer. Eur Urol 70(4):576–585CrossRef

17.

Irwin ML, Crumley D, McTiernan A, Bernstein L, Baumgartner R, Gilliland FD et al (2003) Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity, and Lifestyle (HEAL) study. Cancer 97(7):1746–1757CrossRef

18.

Irwin ML, McTiernan A, Manson JE, Thomson CA, Sternfeld B, Stefanick ML et al (2011) Physical activity and survival in postmenopausal women with breast cancer: results from the women’s health initiative. Cancer Prev Res 4(4):522–529. https://doi.org/10.1158/1940-6207.capr-10-0295 CrossRef

19.

Campbell PT, Patel AV, Newton CC, Jacobs EJ, Gapstur SM (2013) Associations of recreational physical activity and leisure time spent sitting with colorectal cancer survival. J Clin Oncol 31(7):876–885. https://doi.org/10.1200/jco.2012.45.9735 CrossRefPubMed

20.

Kuiper JG, Phipps AI, Neuhouser ML, Chlebowski RT, Thomson CA, Irwin ML et al (2012) Recreational physical activity, body mass index, and survival in women with colorectal cancer. Cancer Causes Control 23(12):1939–1948. https://doi.org/10.1007/s10552-012-0071-2 CrossRefPubMedPubMedCentral

21.

Meyerhardt JA, Giovannucci EL, Holmes MD, Chan AT, Chan JA, Colditz GA et al (2006) Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24(22):3527–3534CrossRef

22.

Schmid D, Behrens G, Arem H, Hart C, Herr W, Jochem C et al (2018) Pre- and post-diagnosis physical activity, television viewing, and mortality among hematologic cancer survivors. PLoS ONE 13(1):e0192078CrossRef

23.

Cannioto RA, LaMonte MJ, Kelemen LE, Risch HA, Eng KH, Minlikeeva AN et al (2016) Recreational physical inactivity and mortality in women with invasive epithelial ovarian cancer: evidence from the Ovarian Cancer Association Consortium. Br J Cancer 115(1):95–101. https://doi.org/10.1038/bjc.2016.153 CrossRefPubMedPubMedCentral

24.

Cannioto RA, Moysich KB (2015) Epithelial ovarian cancer and recreational physical activity: a review of the epidemiological literature and implications for exercise prescription. Gynecol Oncol. https://doi.org/10.1016/j.ygyno.2015.03.016 CrossRefPubMedPubMedCentral

25.

Moorman PG, Jones LW, Akushevich L, Schildkraut JM (2011) Recreational physical activity and ovarian cancer risk and survival. Ann Epidemiol 21(3):178–187. https://doi.org/10.1016/j.annepidem.2010.10.014 CrossRefPubMedPubMedCentral

26.

Zhou Y, Chlebowski R, LaMonte MJ, Bea JW, Qi L, Wallace R et al (2014) Body mass index, physical activity, and mortality in women diagnosed with ovarian cancer: results from the Women’s Health Initiative. Gynecol Oncol 133(1):4–10CrossRef

27.

Liss MA, White M, Natarajan L, Parsons JK (2017) Exercise decreases and smoking increases bladder cancer mortality. Clin Genitourinary Cancer 15(3):391–395. https://doi.org/10.1016/j.clgc.2016.11.006 CrossRef

28.

Wang L, Wang C, Guan S, Cheng Y (2016) Impacts of physically active and under-active on clinical outcomes of esophageal cancer patients undergoing esophagectomy. Am J Cancer Res 6(7):1572–1581PubMedPubMedCentral

29.

Arem H, Park Y, Pelser C, Ballard-Barbash R, Irwin ML, Hollenbeck A et al (2013) Prediagnosis body mass index, physical activity, and mortality in endometrial cancer patients. J Natl Cancer Inst 105(5):342–349. https://doi.org/10.1093/jnci/djs530 CrossRefPubMedPubMedCentral

30.

Arem H, Chlebowski R, Stefanick ML, Anderson G, Wactawski-Wende J, Sims S et al (2013) Body mass index, physical activity, and survival after endometrial cancer diagnosis: results from the Women’s Health Initiative. Gynecol Oncol 128(2):181–186. https://doi.org/10.1016/j.ygyno.2012.10.029 CrossRefPubMed

31.

LaMonte MJ, Buchner DM, Rillamas-Sun E, Di C, Evenson KR, Bellettiere J et al (2017) Accelerometer-measured physical activity and mortality in women aged 63 to 99. J Am Geriatr Soc. https://doi.org/10.1111/jgs.15201 CrossRefPubMedPubMedCentral

32.

Zhong S, Jiang T, Ma T, Zhang X, Tang J, Chen W et al (2014) Association between physical activity and mortality in breast cancer: a meta-analysis of cohort studies. Eur J Epidemiol 29(6):391–404. https://doi.org/10.1007/s10654-014-9916-1 CrossRefPubMed

33.

Li Y, Gu M, Jing F, Cai S, Bao C, Wang J et al (2016) Association between physical activity and all cancer mortality: dose-response meta-analysis of cohort studies. Int J Cancer 138(4):818–832. https://doi.org/10.1002/ijc.29828 CrossRefPubMed

34.

Blair SN, Cheng Y, Holder JS (2001) Is physical activity or physical fitness more important in defining health benefits? Med Sci Sports Exerc 33(6 Suppl):S379–S399; discussion S419-20CrossRef

35.

Janssen I, Jolliffe CJ (2006) Influence of physical activity on mortality in elderly with coronary artery disease. Med Sci Sports Exerc 38(3):418-17CrossRef

36.

Sundquist K, Qvist J, Sundquist J, Johansson SE (2004) Frequent and occasional physical activity in the elderly: a 12-year follow-up study of mortality. Am J Prev Med. 7(1):22–27. https://doi.org/10.1016/j.amepre.2004.03.011 CrossRef

37.

Berger N (2010) Cancer and energy balance: epidemiology. Springer, New YorkCrossRef

38.

McTiernan A (2008) Mechanisms linking physical activity with cancer. Nat Rev Cancer 8(3):205–211. https://doi.org/10.1038/nrc2325 CrossRefPubMed

39.

Byers T (2014) Physical activity and gastric cancer: so what? An epidemiologist’s confession. Cancer Prev Res. 7(1):9–11. https://doi.org/10.1158/1940-6207.capr-13-0400 CrossRef

40.

Hildebrand JS, Gapstur SM, Gaudet MM, Campbell PT, Patel AV (2015) Moderate-to-vigorous physical activity and leisure-time sitting in relation to ovarian cancer risk in a large prospective US cohort. Cancer Causes Control. https://doi.org/10.1007/s10552-015-0656-7 CrossRefPubMed

41.

Sanchis-Gomar F, Lucia A, Yvert T, Ruiz-Casado A, Pareja-Galeano H, Santos-Lozano A et al (2015) Physical inactivity and low fitness deserve more attention to alter cancer risk and prognosis. Cancer Prev Res 8(2):105–10. https://doi.org/10.1158/1940-6207.capr-14-0320 CrossRef

42.

Pedersen L, Idorn M, Olofsson GH, Lauenborg B, Nookaew I, Hansen RH et al (2016) Voluntary running suppresses tumor growth through epinephrine- and IL-6-dependent NK cell mobilization and redistribution. Cell Metab 23(3):554–62. https://doi.org/10.1016/j.cmet.2016.01.011 CrossRefPubMed

43.

Betof AS, Lascola CD, Weitzel D, Landon C, Scarbrough PM, Devi GR et al (2015) Modulation of murine breast tumor vascularity, hypoxia and chemotherapeutic response by exercise. J Natl Cancer Inst 107(5):djv040CrossRef

44.

Moore LV, Harris CD, Carlson SA, Kruger J, Fulton JE (2012) Trends in no leisure-time physical activity–United States, 1988–2010. Res Q Exerc Sport. 83(4):587–91CrossRef

Title: Habitual recreational physical activity is associated with significantly improved survival in cancer patients: evidence from the Roswell Park Data Bank and BioRepository
Authors: Rikki A. Cannioto
Shruti Dighe
Martin C. Mahoney
Kirsten B. Moysich
Arindam Sen
Karen Hulme
Susan E. McCann
Christine B. Ambrosone
Publication date: 01-01-2019
Publisher: Springer International Publishing
Published in: Cancer Causes & Control / Issue 1/2019
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-018-1101-5

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