Skip to main content

Advertisement

SpringerLink
Log in

Association of change in physical activity and body weight with quality of life and mortality in colorectal cancer: a systematic review and meta-analysis

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

A systematic review and a meta-analysis were performed to assess the associations between change over time in physical activity and weight and quality of life and mortality in colorectal cancer patients.

Methods

The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched for English language articles published between January 1, 1990 and October 7, 2013. These articles reported results for changes in physical activity and body weight, assessed at pre- to post-diagnosis or at post-diagnosis only. A random effects model was used to analyze pooled quality of life and mortality estimates.

Results

Seven eligible studies were identified and analyzed. Increased physical activity was associated with higher overall quality of life scores (N = 3 studies; standardized mean difference (SMD) = 0.74, 95 % confidence interval (CI) = 0.66–0.82), reduced disease-specific mortality risk (hazard ratio (HRpooled) = 0.70, 95 % CI = 0.55–0.85), and reduced overall mortality (HRpooled = 0.75, CI = 0.62–0.87) (N = 2 studies). Weight gain was not associated with disease-specific (HRpooled = 1.02, CI = 0.84–1.20) or overall (HRpooled = 1.03, CI = 0.86–1.19) mortality (N = 3 studies).

Conclusions

Increased physical activity was associated with improved quality of life, a reduced risk of colorectal cancer, and overall mortality rate. Given the paucity of the literature published on this topic, this finding should be interpreted with caution.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D and Bray F (2013) GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer, http://globocan.iarc.fr, accessed on 18/02/2014.

  2. SEER Stat Fact Sheets: colon and rectum (2010). vol 2011. National Cancer Institute, Bethesda

  3. Maddams J, Brewster D, Gavin A, Steward J, Elliott J, Utley M, Moller H (2009) Cancer prevalence in the United Kingdom: estimates for 2008. Br J Cancer 101(3):541–547

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Demark-Wahnefried W, Pinto BM, Gritz ER (2006) Promoting health and physical function among cancer survivors: potential for prevention and questions that remain. J Clin Oncol 24(32):5125–5131

    Article  PubMed  Google Scholar 

  5. Doyle C, Kushi LH, Byers T, Courneya KS, Demark-Wahnefried W, Grant B, McTiernan A, Rock CL, Thompson C, Gansler T, Andrews KS (2006) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin 56(6):323–353

    Article  PubMed  Google Scholar 

  6. Demark-Wahnefried W, Jones LW (2008) Promoting a healthy lifestyle among cancer survivors. Hematol Oncol Clin N Am 22(2):319–342, viii

    Article  Google Scholar 

  7. Vrieling A, Kampman E (2010) The role of body mass index, physical activity, and diet in colorectal cancer recurrence and survival: a review of the literature. Am J Clin Nutr 92(3):471–490

    Article  CAS  PubMed  Google Scholar 

  8. Davies NJ, Batehup L, Thomas R (2011) The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Cancer 105(Suppl 1):S52–S73. doi:10.1038/bjc.2011.423

    Article  PubMed Central  PubMed  Google Scholar 

  9. Ballard-Barbash R, Friedenreich CM, Courneya KS, Siddiqi SM, McTiernan A, Alfano CM (2012) Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst 104(11):815–840

    Article  PubMed Central  PubMed  Google Scholar 

  10. Mishra SI, Scherer RW, Geigle PM, Berlanstein DR, Topaloglu O, Gotay CC, Snyder C (2012) Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev 8, CD007566

    PubMed  Google Scholar 

  11. Mishra SI, Scherer RW, Snyder C, Geigle PM, Berlanstein DR, Topaloglu O (2012) Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev 8, CD008465. doi:10.1002/14651858.CD008465.pub2

    PubMed  Google Scholar 

  12. Meyerhardt JA, Heseltine D, Niedzwiecki D, Hollis D, Saltz LB, Mayer RJ, Thomas J, Nelson H, Whittom R, Hantel A, Schilsky RL, Fuchs CS (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24(22):3535–3541

    Article  PubMed  Google Scholar 

  13. Meyerhardt JA, Giovannucci EL, Ogino S, Kirkner GJ, Chan AT, Willett W, Fuchs CS (2009) Physical activity and male colorectal cancer survival. Arch Intern Med 169(22):2102–2108

    Article  PubMed Central  PubMed  Google Scholar 

  14. Kuiper JG, Phipps AI, Neuhouser ML, Chlebowski RT, Thomson CA, Irwin ML, Lane DS, Wactawski-Wende J, Hou L, Jackson RD, Kampman E, Newcomb PA (2012) Recreational physical activity, body mass index, and survival in women with colorectal cancer. Cancer Causes Control 23(12):1939–1948. doi:10.1007/s10552-012-0071-2

    Article  PubMed Central  PubMed  Google Scholar 

  15. 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

    Article  PubMed  Google Scholar 

  16. Haydon AM, Macinnis RJ, English DR, Giles GG (2006) Effect of physical activity and body size on survival after diagnosis with colorectal cancer. Gut 55(1):62–67

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Doria-Rose VP, Newcomb PA, Morimoto LM, Hampton JM, Trentham-Dietz A (2006) Body mass index and the risk of death following the diagnosis of colorectal cancer in postmenopausal women (United States). Cancer Causes Control 17(1):63–70

    Article  PubMed  Google Scholar 

  18. Dignam JJ, Polite BN, Yothers G, Raich P, Colangelo L, O’Connell MJ, Wolmark N (2006) Body mass index and outcomes in patients who receive adjuvant chemotherapy for colon cancer. J Natl Cancer Inst 98(22):1647–1654

    Article  PubMed  Google Scholar 

  19. Mosher CE, Sloane R, Morey MC, Snyder DC, Cohen HJ, Miller PE, Demark-Wahnefried W (2009) Associations between lifestyle factors and quality of life among older long-term breast, prostate, and colorectal cancer survivors. Cancer 115(17):4001–4009

    Article  PubMed Central  PubMed  Google Scholar 

  20. Buffart LM, Thong MS, Schep G, Chinapaw MJ, Brug J, van de Poll-Franse LV (2012) Self-reported physical activity: its correlates and relationship with health-related quality of life in a large cohort of colorectal cancer survivors. PLoS One 7(5):e36164. doi:10.1371/journal.pone.0036164

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Grimmett C, Bridgewater J, Steptoe A, Wardle J (2011) Lifestyle and quality of life in colorectal cancer survivors. Qual Life Res 20(8):1237–1245

    Article  PubMed  Google Scholar 

  22. Peddle CJ, Au HJ, Courneya KS (2008) Associations between exercise, quality of life, and fatigue in colorectal cancer survivors. Dis Colon Rectum 51(8):1242–1248

    Article  PubMed  Google Scholar 

  23. Blanchard CM, Courneya KS, Stein K (2008) Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. J Clin Oncol 26(13):2198–2204

    Article  PubMed  Google Scholar 

  24. Hawkes AL, Gollschewski S, Lynch BM, Chambers S (2009) A telephone-delivered lifestyle intervention for colorectal cancer survivors ‘CanChange’: a pilot study. Psycho-Oncology 18(4):449–455. doi:10.1002/pon.1527

    Article  PubMed  Google Scholar 

  25. Pekmezi DW, Demark-Wahnefried W (2011) Updated evidence in support of diet and exercise interventions in cancer survivors. Acta Oncol 50(2):167–178. doi:10.3109/0284186X.2010.529822

    Article  PubMed Central  PubMed  Google Scholar 

  26. Blanchard CM, Baker F, Denniston MM, Courneya KS, Hann DM, Gesme DH, Reding D, Flynn T, Kennedy JS (2003) Is absolute amount or change in exercise more associated with quality of life in adult cancer survivors? Prev Med 37(5):389–395

    Article  PubMed  Google Scholar 

  27. Cancer Survivorship Research (NCI) http://cancercontrol.cancer.gov/ocs/definitions.html; accessed 07 October 2013.

  28. Mols F, Vingerhoets AJ, Coebergh JW, van de Poll-Franse LV (2005) Quality of life among long-term breast cancer survivors: a systematic review. Eur J Cancer 41(17):2613–2619

    Article  PubMed  Google Scholar 

  29. DeWys WD, Walters K (1975) Abnormalities of taste sensation in cancer patients. Cancer 36(5):1888–1896

    Article  CAS  PubMed  Google Scholar 

  30. Tisdale MJ (2010) Cancer cachexia. Curr Opin Gastroenterol 26(2):146–151. doi:10.1097/MOG.0b013e3283347e77

    Article  PubMed  Google Scholar 

  31. Lynch BM, Cerin E, Owen N, Hawkes AL, Aitken JF (2008) Prospective relationships of physical activity with quality of life among colorectal cancer survivors. J Clin Oncol 26(27):4480–4487

    Article  PubMed  Google Scholar 

  32. DerSimonian R, Kacker R (2007) Random-effects model for meta-analysis of clinical trials: an update. Contemp Clin Trials 28(2):105–114

    Article  PubMed  Google Scholar 

  33. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  34. Greenland S (1987) Quantitative methods in the review of epidemiologic literature. Epidemiol Rev 9:1–30

    CAS  PubMed  Google Scholar 

  35. Baade PD, Meng X, Youl PH, Aitken JF, Dunn J, Chambers SK (2011) The impact of body mass index and physical activity on mortality among patients with colorectal cancer in Queensland, Australia. Cancer Epidemiol Biomarkers Prev 20(7):1410–1420

    Article  PubMed  Google Scholar 

  36. Campbell PT, Newton CC, Dehal AN, Jacobs EJ, Patel AV, Gapstur SM (2012) Impact of body mass index on survival after colorectal cancer diagnosis: the Cancer Prevention Study-II Nutrition Cohort. J Clin Oncol 30(1):42–52

    Article  PubMed  Google Scholar 

  37. Courneya KS, Friedenreich CM (1997) Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. J Altern Complement Med 3(3):215–226

    Article  CAS  PubMed  Google Scholar 

  38. Courneya KS, Friedenreich CM, Quinney HA, Fields AL, Jones LW, Fairey AS (2003) A randomized trial of exercise and quality of life in colorectal cancer survivors. Eur J Cancer Care (Engl) 12(4):347–357

    Article  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  40. Meyerhardt JA, Niedzwiecki D, Hollis D, Saltz LB, Mayer RJ, Nelson H, Whittom R, Hantel A, Thomas J, Fuchs CS (2008) Impact of body mass index and weight change after treatment on cancer recurrence and survival in patients with stage III colon cancer: findings from Cancer and Leukemia Group B 89803. J Clin Oncol 26(25):4109–4115

    Article  PubMed Central  PubMed  Google Scholar 

  41. Pinto BM, Papandonatos GD, Goldstein MG, Marcus BH, Farrell N (2011) Home-based physical activity intervention for colorectal cancer survivors. Psycho-Oncology 22(1):54–64. doi:10.1002/pon.2047

    Article  PubMed  Google Scholar 

  42. Hawkes AL, Chambers SK, Pakenham KI, Patrao TA, Baade PD, Lynch BM, Aitken JF, Meng X, Courneya KS (2013) Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: a randomized controlled trial. J Clin Oncol 31(18):2313–2321

    Article  PubMed  Google Scholar 

  43. Courneya KS, Friedenreich CM, Arthur K, Bobick TM (1999) Understanding exercise motivation in colorectal cancer patients: a prospective study using the theory of planned behavior. Rehabil Psychol 44(1):68–84

    Article  Google Scholar 

  44. Inoue-Choi M, Lazovich D, Prizment AE, Robien K (2013) Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention is associated with better health-related quality of life among elderly female cancer survivors. J Clin Oncol 31(14):1758–1766. doi:10.1200/JCO.2012.45.4462

    Article  PubMed Central  PubMed  Google Scholar 

  45. Kroenke CH, Chen WY, Rosner B, Holmes MD (2005) Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol 23(7):1370–1378

    Article  PubMed  Google Scholar 

  46. Demark-Wahnefried W, Peterson BL, Winer EP, Marks L, Aziz N, Marcom PK, Blackwell K, Rimer BK (2001) Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol 19(9):2381–2389

    CAS  PubMed  Google Scholar 

  47. Ramsey SD, Andersen MR, Etzioni R, Moinpour C, Peacock S, Potosky A, Urban N (2000) Quality of life in survivors of colorectal carcinoma. Cancer 88(6):1294–1303

    Article  CAS  PubMed  Google Scholar 

  48. Chambers SK, Lynch BM, Aitken J, Baade P (2009) Relationship over time between psychological distress and physical activity in colorectal cancer survivors. J Clin Oncol 27(10):1600–1606. doi:10.1200/JCO.2008.18.5157

    Article  PubMed  Google Scholar 

  49. Chambers SK, Meng X, Youl P, Aitken J, Dunn J, Baade P (2012) A five-year prospective study of quality of life after colorectal cancer. Qual Life Res 21(9):1551–1564. doi:10.1007/s11136-011-0067-5

    Article  PubMed  Google Scholar 

  50. Schlesinger S, Walter J, Hampe J, von Schonfels W, Hinz S, Kuchler T, Jacobs G, Schafmayer C, Nothlings U (2014) Lifestyle factors and health-related quality of life in colorectal cancer survivors. Cancer Causes Control 25(1):99–110. doi:10.1007/s10552-013-0313-y

    Article  PubMed  Google Scholar 

  51. Inoue-Choi M, Robien K, Lazovich D (2013) Adherence to the WCRF/AICR guidelines for cancer prevention is associated with lower mortality among older female cancer survivors. Cancer Epidemiol Biomarkers Prev 22(5):792–802. doi:10.1158/1055-9965.EPI-13-0054

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by internal funding from the department of Public Health of the Erasmus MC, University Medical Center Rotterdam. We acknowledge the support of the librarian, Louis Volkers.

Funding

This work was supported by internal funding from the department of Public Health of the Erasmus MC, University Medical Center Rotterdam. The funder did not participate in the study design, data collection, data analysis and interpretation, writing the manuscript, or in the decision to submit the paper for publication.

Conflict of interest

The authors have no conflicts of interest to report.

Author information

Authors and Affiliations

  1. Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands

    S. J. Otto, I. J. Korfage, S. Polinder, A. van der Heide, E. de Vries, J. A. C. Rietjens & I. Soerjomataram

Authors
  1. S. J. Otto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I. J. Korfage
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Polinder
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. van der Heide
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E. de Vries
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. A. C. Rietjens
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. I. Soerjomataram
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. J. Otto.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Otto, S.J., Korfage, I.J., Polinder, S. et al. Association of change in physical activity and body weight with quality of life and mortality in colorectal cancer: a systematic review and meta-analysis. Support Care Cancer 23, 1237–1250 (2015). https://doi.org/10.1007/s00520-014-2480-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-014-2480-0

Keywords

Search

Navigation