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Published in: Journal of Cancer Survivorship 4/2018

01-08-2018

Associations between physical activity and comorbidities in Korean cancer survivors

Authors: Dong-Woo Kang, Eun-Young Lee, Ki Yong An, Jihee Min, Justin Y. Jeon, Kerry S. Courneya

Published in: Journal of Cancer Survivorship | Issue 4/2018

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Abstract

Purpose

To examine the associations between physical activity, metabolic risk factors, and comorbidities in Korean cancer survivors.

Methods

We used multiple cross-sectional data sets from the 2007–2013 Korean National Health and Nutrition Examination Surveys (KNHANES) that included 1225 cancer survivors. Physical activity and comorbidities were self-reported. Metabolic risk factors were measured via blood analyses and included fasting glucose, insulin, total cholesterol, triglycerides, and blood pressure.

Results

The sample was 38.4% male with a mean age of 59.9 ± 12.4 years. The most common cancers were stomach (22.5%), cervical (14.6%), breast (14.4%), and colorectal (11.8%). Cancer survivors meeting aerobic physical activity guidelines, compared to those completely inactive, had significantly lower fasting glucose (p = .001), HbA1c (p = .006), and systolic blood pressure (p = .001), and significantly lower risks of hypertension (odds ratio [OR] = 0.55, 95% confidential interval [CI] = 0.32 to 0.93), diabetes (OR = 0.64, 95% CI = 0.43 to 0.95), and arthritis (OR = 0.64, 95% CI = 0.41 to 0.99). Moreover, cancer survivors meeting strength exercise guidelines, compared to those not meeting guidelines, had significantly lower levels of fasting glucose (p = .001), HbA1c (p < .001), and total cholesterol (p = .031), and significantly lower risks of arthritis (OR = 0.42, 95% CI = 0.25 to 0.85) and back pain (OR = 0.50, 95% CI = 0.30 to 0.83).

Conclusion

Aerobic physical activity and strength exercise were significantly associated with lower risks of metabolic disturbances and comorbidities in Korean cancer survivors.

Implications for Cancer Survivors

Cancer survivors should engage in at least 150 min/week of aerobic exercise and at least 2 days/week of strength exercise to lower their risk of metabolic disturbances and comorbidities.
Literature
1.
go back to reference Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci. 2003;58(1):M82–91.CrossRef Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci. 2003;58(1):M82–91.CrossRef
2.
go back to reference Schultz PN, Beck ML, Stava C, Vassilopoulou-Sellin R. Health profiles in 5836 long-term cancer survivors. Int J Cancer. 2003;104(4):488–95.CrossRefPubMed Schultz PN, Beck ML, Stava C, Vassilopoulou-Sellin R. Health profiles in 5836 long-term cancer survivors. Int J Cancer. 2003;104(4):488–95.CrossRefPubMed
3.
go back to reference Hong CC, Ambrosone CB, Goodwin PJ. Comorbidities and their management: potential impact on breast cancer outcomes. Adv Exp Med Biol. 2015;862:155–75.CrossRefPubMed Hong CC, Ambrosone CB, Goodwin PJ. Comorbidities and their management: potential impact on breast cancer outcomes. Adv Exp Med Biol. 2015;862:155–75.CrossRefPubMed
4.
go back to reference Wu AH, Kurian AW, Kwan ML, John EM, Lu Y, Keegan TH, et al. Diabetes and other comorbidities in breast cancer survival by race/ethnicity: the California Breast Cancer Survivorship Consortium (CBCSC). Cancer Epidemiol Biomark Prev. 2015;24(2):361–8.CrossRef Wu AH, Kurian AW, Kwan ML, John EM, Lu Y, Keegan TH, et al. Diabetes and other comorbidities in breast cancer survival by race/ethnicity: the California Breast Cancer Survivorship Consortium (CBCSC). Cancer Epidemiol Biomark Prev. 2015;24(2):361–8.CrossRef
5.
go back to reference Ye F, Moon DH, Carpenter WR, Reeve BB, Usinger DS, Green RL, et al. Comparison of patient report and medical records of comorbidities: results from a population-based cohort of patients with prostate cancer. JAMA oncol. 2017;3(8):1035–42.CrossRefPubMedPubMedCentral Ye F, Moon DH, Carpenter WR, Reeve BB, Usinger DS, Green RL, et al. Comparison of patient report and medical records of comorbidities: results from a population-based cohort of patients with prostate cancer. JAMA oncol. 2017;3(8):1035–42.CrossRefPubMedPubMedCentral
6.
go back to reference Sogaard M, Thomsen RW, Bossen KS, Sorensen H, Norgaard M. The impact of comorbidity on cancer survival: a review. Clin Epidemiol. 2013;5(Suppl 1):3–29.CrossRefPubMedPubMedCentral Sogaard M, Thomsen RW, Bossen KS, Sorensen H, Norgaard M. The impact of comorbidity on cancer survival: a review. Clin Epidemiol. 2013;5(Suppl 1):3–29.CrossRefPubMedPubMedCentral
7.
go back to reference Deimling GT, Bowman KF, Sterns S, Wagner LJ, Kahana B. Cancer-related health worries and psychological distress among older adult, long-term cancer survivors. Psychooncology. 2006;15(4):306–20.CrossRefPubMed Deimling GT, Bowman KF, Sterns S, Wagner LJ, Kahana B. Cancer-related health worries and psychological distress among older adult, long-term cancer survivors. Psychooncology. 2006;15(4):306–20.CrossRefPubMed
8.
go back to reference Lustberg MB, Reinbolt RE, Shapiro CL. Bone health in adult cancer survivorship. J Clin Oncol. 2012;30(30):3665–74.CrossRefPubMed Lustberg MB, Reinbolt RE, Shapiro CL. Bone health in adult cancer survivorship. J Clin Oncol. 2012;30(30):3665–74.CrossRefPubMed
9.
go back to reference Speck RM, Courneya KS, Mâsse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4(2):87–100.CrossRefPubMed Speck RM, Courneya KS, Mâsse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4(2):87–100.CrossRefPubMed
10.
go back to reference Schmitz KH, Holtzman J, Courneya KS, Mâsse LC, Duval S, Kane R. Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev. 2005;14(7):1588–95.CrossRef Schmitz KH, Holtzman J, Courneya KS, Mâsse LC, Duval S, Kane R. Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev. 2005;14(7):1588–95.CrossRef
11.
go back to reference Friedenreich CM, Orenstein MR. Physical activity and cancer prevention: etiologic evidence and biological mechanisms. J Nutr. 2002;132(11):3456S–64S.CrossRefPubMed Friedenreich CM, Orenstein MR. Physical activity and cancer prevention: etiologic evidence and biological mechanisms. J Nutr. 2002;132(11):3456S–64S.CrossRefPubMed
12.
go back to reference Bao PP, Zheng Y, Nechuta S, Gu K, Cai H, Peng P, et al. Exercise after diagnosis and metabolic syndrome among breast cancer survivors: a report from the Shanghai Breast Cancer Survival Study. Cancer Causes Control. 2013;24(9):1747–56.CrossRefPubMed Bao PP, Zheng Y, Nechuta S, Gu K, Cai H, Peng P, et al. Exercise after diagnosis and metabolic syndrome among breast cancer survivors: a report from the Shanghai Breast Cancer Survival Study. Cancer Causes Control. 2013;24(9):1747–56.CrossRefPubMed
13.
go back to reference Keats MR, Cui Y, Grandy SA, Parker L. Cardiovascular disease and physical activity in adult cancer survivors: a nested, retrospective study from the Atlantic PATH cohort. J Cancer Surviv. 2017;11(2):264–73.CrossRefPubMed Keats MR, Cui Y, Grandy SA, Parker L. Cardiovascular disease and physical activity in adult cancer survivors: a nested, retrospective study from the Atlantic PATH cohort. J Cancer Surviv. 2017;11(2):264–73.CrossRefPubMed
14.
go back to reference Vardar-Yagli N, Sener G, Saglam M, Calik-Kutukcu E, Arikan H, Inal-Ince D, et al. Associations among physical activity, comorbidity, functional capacity, peripheral muscle strength and depression in breast cancer survivors. Asian Pac J Cancer Prev. 2015;16(2):585–9.CrossRefPubMed Vardar-Yagli N, Sener G, Saglam M, Calik-Kutukcu E, Arikan H, Inal-Ince D, et al. Associations among physical activity, comorbidity, functional capacity, peripheral muscle strength and depression in breast cancer survivors. Asian Pac J Cancer Prev. 2015;16(2):585–9.CrossRefPubMed
16.
go back to reference Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, et al. Data resource profile: the Korea national health and nutrition examination survey (KNHANES). Int J Epidemiol. 2014;43(1):69–77.CrossRefPubMedPubMedCentral Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, et al. Data resource profile: the Korea national health and nutrition examination survey (KNHANES). Int J Epidemiol. 2014;43(1):69–77.CrossRefPubMedPubMedCentral
17.
go back to reference Oh JY, Yang YJ, Kim BS, Kang JH. Validity and reliability of Korean version of International Physical Activity Questionnaire (IPAQ) short form. J Korean Acad Fam Med. 2007;28(7):532–41. Oh JY, Yang YJ, Kim BS, Kang JH. Validity and reliability of Korean version of International Physical Activity Questionnaire (IPAQ) short form. J Korean Acad Fam Med. 2007;28(7):532–41.
18.
go back to reference Chun MY. Validity and reliability of Korean version of international physical activity questionnaire short form in the elderly. Korean J Fam Med. 2012;33(3):144–51.CrossRefPubMedPubMedCentral Chun MY. Validity and reliability of Korean version of international physical activity questionnaire short form in the elderly. Korean J Fam Med. 2012;33(3):144–51.CrossRefPubMedPubMedCentral
19.
go back to reference Schmitz K, Courneya K, Matthews C, Demark-Wahnefried W, Galvao D, Pinto B, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–26.CrossRefPubMed Schmitz K, Courneya K, Matthews C, Demark-Wahnefried W, Galvao D, Pinto B, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–26.CrossRefPubMed
20.
go back to reference Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4):242–74.CrossRef Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4):242–74.CrossRef
21.
go back to reference Fuchs VR. Reflections on the socio-economic correlates of health. J Health Econ. 2004;23(4):653–61.CrossRefPubMed Fuchs VR. Reflections on the socio-economic correlates of health. J Health Econ. 2004;23(4):653–61.CrossRefPubMed
22.
go back to reference Meigs JB, Wilson PW, Fox CS, Vasan RS, Nathan DM, Sullivan LM, et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab. 2006;91(8):2906–12.CrossRefPubMed Meigs JB, Wilson PW, Fox CS, Vasan RS, Nathan DM, Sullivan LM, et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab. 2006;91(8):2906–12.CrossRefPubMed
23.
go back to reference Geraci JM, Escalante CP, Freeman JL, Goodwin JS. Comorbid disease and cancer: the need for more relevant conceptual models in health services research. J Clin Oncol. 2005;23(30):7399–404.CrossRefPubMedPubMedCentral Geraci JM, Escalante CP, Freeman JL, Goodwin JS. Comorbid disease and cancer: the need for more relevant conceptual models in health services research. J Clin Oncol. 2005;23(30):7399–404.CrossRefPubMedPubMedCentral
24.
go back to reference Coughlin SS, Calle EE, Teras LR, Petrelli J, Thun MJ. Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults. Am J Epidemiol. 2004;159(12):1160–7.CrossRefPubMed Coughlin SS, Calle EE, Teras LR, Petrelli J, Thun MJ. Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults. Am J Epidemiol. 2004;159(12):1160–7.CrossRefPubMed
25.
go back to reference Currie CJ, Poole CD, Jenkins-Jones S, Gale EA, Johnson JA, Morgan CL. Mortality after incident cancer in people with and without type 2 diabetes impact of metformin on survival. Diabetes Care. 2012;35(2):299–304.CrossRefPubMedPubMedCentral Currie CJ, Poole CD, Jenkins-Jones S, Gale EA, Johnson JA, Morgan CL. Mortality after incident cancer in people with and without type 2 diabetes impact of metformin on survival. Diabetes Care. 2012;35(2):299–304.CrossRefPubMedPubMedCentral
26.
go back to reference Jeon JY, Jeong DH, Park MG, Lee J-W, Chu SH, Park J-H, et al. Impact of diabetes on oncologic outcome of colorectal cancer patients: colon vs. rectal cancer. PLoS One. 2013;8(2):e55196.CrossRefPubMedPubMedCentral Jeon JY, Jeong DH, Park MG, Lee J-W, Chu SH, Park J-H, et al. Impact of diabetes on oncologic outcome of colorectal cancer patients: colon vs. rectal cancer. PLoS One. 2013;8(2):e55196.CrossRefPubMedPubMedCentral
27.
go back to reference American Diabetes Association. Physical activity/exercise and diabetes. Diabetes Care. 2004;27(suppl 1):s58–62. American Diabetes Association. Physical activity/exercise and diabetes. Diabetes Care. 2004;27(suppl 1):s58–62.
28.
29.
go back to reference Cairns RA, Harris IS, Mak TW. Regulation of cancer cell metabolism. Nat Rev Cancer. 2011;11(2):85–95.CrossRefPubMed Cairns RA, Harris IS, Mak TW. Regulation of cancer cell metabolism. Nat Rev Cancer. 2011;11(2):85–95.CrossRefPubMed
30.
go back to reference Yun J, Rago C, Cheong I, Pagliarini R, Angenendt P, Rajagopalan H, et al. Glucose deprivation contributes to the development of KRAS pathway mutations in tumor cells. Science. 2009;325(5947):1555–9.CrossRefPubMedPubMedCentral Yun J, Rago C, Cheong I, Pagliarini R, Angenendt P, Rajagopalan H, et al. Glucose deprivation contributes to the development of KRAS pathway mutations in tumor cells. Science. 2009;325(5947):1555–9.CrossRefPubMedPubMedCentral
31.
go back to reference Gillies RJ, Robey I, Gatenby RA. Causes and consequences of increased glucose metabolism of cancers. J Nucl Med. 2008;49(Suppl 2):24S–42S.CrossRefPubMed Gillies RJ, Robey I, Gatenby RA. Causes and consequences of increased glucose metabolism of cancers. J Nucl Med. 2008;49(Suppl 2):24S–42S.CrossRefPubMed
33.
go back to reference Dyer A, Berkson D, Stamler J, Lindberg H, Stevens E. High blood-pressure: a risk factor for cancer mortality? Lancet. 1975;305(7915):1051–6.CrossRef Dyer A, Berkson D, Stamler J, Lindberg H, Stevens E. High blood-pressure: a risk factor for cancer mortality? Lancet. 1975;305(7915):1051–6.CrossRef
34.
go back to reference Grossman E, Messerli FH, Boyko V, Goldbourt U. Is there an association between hypertension and cancer mortality? Am J Med. 2002;112(6):479–86.CrossRefPubMed Grossman E, Messerli FH, Boyko V, Goldbourt U. Is there an association between hypertension and cancer mortality? Am J Med. 2002;112(6):479–86.CrossRefPubMed
35.
go back to reference Hooning MJ, Botma A, Aleman BM, Baaijens MH, Bartelink H, Klijn JG, et al. Long-term risk of cardiovascular disease in 10-year survivors of breast cancer. J Natl Cancer Inst. 2007;99(5):365–75.CrossRefPubMed Hooning MJ, Botma A, Aleman BM, Baaijens MH, Bartelink H, Klijn JG, et al. Long-term risk of cardiovascular disease in 10-year survivors of breast cancer. J Natl Cancer Inst. 2007;99(5):365–75.CrossRefPubMed
36.
go back to reference Haugnes HS, Wethal T, Aass N, Dahl O, Klepp O, Langberg CW, et al. Cardiovascular risk factors and morbidity in long-term survivors of testicular cancer: a 20-year follow-up study. J Clin Oncol. 2010;28(30):4649–57.CrossRefPubMed Haugnes HS, Wethal T, Aass N, Dahl O, Klepp O, Langberg CW, et al. Cardiovascular risk factors and morbidity in long-term survivors of testicular cancer: a 20-year follow-up study. J Clin Oncol. 2010;28(30):4649–57.CrossRefPubMed
37.
go back to reference Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011;13(3):1–9.CrossRef Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011;13(3):1–9.CrossRef
38.
go back to reference VBd S, Silva EN, Ribeiro ML, WdA M. Hypertension in patients with cancer. Arq Bras Cardiol. 2015;104(3):246–52. VBd S, Silva EN, Ribeiro ML, WdA M. Hypertension in patients with cancer. Arq Bras Cardiol. 2015;104(3):246–52.
39.
go back to reference Sowers JR, Epstein M, Frohlich ED. Diabetes, hypertension, and cardiovascular disease an update. Hypertension. 2001;37(4):1053–9.CrossRefPubMed Sowers JR, Epstein M, Frohlich ED. Diabetes, hypertension, and cardiovascular disease an update. Hypertension. 2001;37(4):1053–9.CrossRefPubMed
40.
go back to reference Arroll B, Beaglehole R. Does physical activity lower blood pressure: a critical review of the clinical trials. J Clin Epidemiol. 1992;45(5):439–47.CrossRefPubMed Arroll B, Beaglehole R. Does physical activity lower blood pressure: a critical review of the clinical trials. J Clin Epidemiol. 1992;45(5):439–47.CrossRefPubMed
41.
go back to reference Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136(7):493–503.CrossRefPubMed Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136(7):493–503.CrossRefPubMed
43.
go back to reference Amiri A, Rafiei A. Analysis of patients with post-chemotherapy arthralgia and arthritis in breast cancer. Indian J Med Sci. 2010;64(5):197–203.CrossRefPubMed Amiri A, Rafiei A. Analysis of patients with post-chemotherapy arthralgia and arthritis in breast cancer. Indian J Med Sci. 2010;64(5):197–203.CrossRefPubMed
44.
45.
go back to reference Min JH, Kim JY, Justin JY. The characteristics Korean cancer patients’ physical activity participation: focus on five major cancers: the Korea National Health and Nutrition Examination Survey 2009-2013. Korean J Phys Educ. 2015;54(6):389–97. Min JH, Kim JY, Justin JY. The characteristics Korean cancer patients’ physical activity participation: focus on five major cancers: the Korea National Health and Nutrition Examination Survey 2009-2013. Korean J Phys Educ. 2015;54(6):389–97.
46.
go back to reference Kang D-W, Chung JY, Lee MK, Lee J, Park J-H, Kim D-i, et al. Exercise barriers in Korean colorectal cancer patients. Asian Pac J Cancer Prev. 2014;15(18):7539–45.CrossRefPubMed Kang D-W, Chung JY, Lee MK, Lee J, Park J-H, Kim D-i, et al. Exercise barriers in Korean colorectal cancer patients. Asian Pac J Cancer Prev. 2014;15(18):7539–45.CrossRefPubMed
47.
go back to reference Courneya KS, Friedenreich CM, Quinney HA, Fields AL, Jones LW, Vallance JK, et al. A longitudinal study of exercise barriers in colorectal cancer survivors participating in a randomized controlled trial. Ann Behav Med. 2005;29(2):147–53.CrossRefPubMed Courneya KS, Friedenreich CM, Quinney HA, Fields AL, Jones LW, Vallance JK, et al. A longitudinal study of exercise barriers in colorectal cancer survivors participating in a randomized controlled trial. Ann Behav Med. 2005;29(2):147–53.CrossRefPubMed
48.
go back to reference Lee PH, Macfarlane DJ, Lam T, Stewart SM. Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act. 2011;8(1):1.CrossRef Lee PH, Macfarlane DJ, Lam T, Stewart SM. Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act. 2011;8(1):1.CrossRef
49.
go back to reference Lynch BM, Dunstan DW, Healy GN, Winkler E, Eakin E, Owen N. Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: findings from NHANES (2003–2006). Cancer Causes Control. 2010;21(2):283–8.CrossRefPubMed Lynch BM, Dunstan DW, Healy GN, Winkler E, Eakin E, Owen N. Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: findings from NHANES (2003–2006). Cancer Causes Control. 2010;21(2):283–8.CrossRefPubMed
Metadata
Title
Associations between physical activity and comorbidities in Korean cancer survivors
Authors
Dong-Woo Kang
Eun-Young Lee
Ki Yong An
Jihee Min
Justin Y. Jeon
Kerry S. Courneya
Publication date
01-08-2018
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 4/2018
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-018-0683-y

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