The impact of physical activity on all-cause mortality in men and women after a cancer diagnosis
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Existing information regarding the impact of physical activity after a cancer diagnosis on all-cause mortality is limited. We examined the association between different types of physical activity (domestic, walking, sports) and mortality in 293 participants (65.5% women) with a cancer registration prior to the baseline assessment.
Participants were drawn from the Scottish Health Surveys (1995, 1998, 2003) that were linked to a national database of cancer registrations and deaths. The main outcome was all-cause mortality during a mean follow-up period of 5.9 ± 3.2 years. Cox proportional hazards models were used to estimate the risk of all-cause mortality by levels of physical activity.
There were 78 deaths during follow-up. The lowest risks for all-cause mortality were seen in sports activity groups [multivariable-adjusted hazard ratio (HR) for any compared with groups of no sports: 0.47, 95% CI 0.23–0.96, p = 0.039] although light and moderate activity such as domestic activity (HR = 1.04, 0.60–1.80) and regular walking (HR = 0.95, 0.57–1.56) did not confer protection.
Participation in an average of more than three sessions of vigorous exercise per week for at least 20 min/session was associated with the lowest risks of all-cause mortality following a cancer diagnosis. Vigorous physical activity could therefore be a more important determinant of survival than duration or total volume of exercise in cancer survivors.
KeywordsExercise Cancer Mortality Survival Epidemiology
The authors received grant funding from the British Heart Foundation, UK (MH), and the National Institute for Health Research, UK (ES). The Scottish Health Survey is funded by the Scottish Executive. The views expressed in this article are those of the authors and not necessarily of the funding bodies. We declare that the funders played no role in the concept and design of the study, analysis or interpretation of data, or drafting and critical revision of the manuscript.
All authors were responsible for the study concept and design, interpretation of data, and drafting and critical revision of the manuscript. ES was responsible for the acquisition of the data. Statistical analysis and preparation of the data was performed by MH and ES. All authors approved the final version of the article. MH is the guarantor.
- 1.Cancer Research UK. UK Cancer incidence statistics. http://info.cancerresearchuk.org/cancerstats. Accessed Feb 2008
- 2.Information Services Division. Cancer in Scotland (2007) NHS National Services Scotland. http://www.isdscotland.org/isd/5323.html. Accessed Feb 2008
- 7.Doyle C, Kushi LH, Byers T, Courneya KS, Demark-Wahnefried W, Grant B, McTiernan A, Rock CL, Thompson C, Gansler T, Andrews KS, The 2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society (2006) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin 56:323–353PubMedCrossRefGoogle Scholar
- 8.Department of Health (2004) At least five a week: evidence on the impact of physical activity and its relationship to health. A report from the Chief Medical OfficerGoogle Scholar
- 10.Holick CN, Newcomb PA, Trentham-Dietz A, Titus-Ernstoff L, Bersch AJ, Stampfer MJ, Baron JA, Egan KM, Willett WC (2008) Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarkers Prev 17:379–386. doi: 10.1158/1055-9965.EPI-07-0771 PubMedCrossRefGoogle Scholar
- 11.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 24:3535–3541. doi: 10.1200/JCO.2006.06.0863 PubMedCrossRefGoogle Scholar
- 14.The Scottish Government Statistics. Scottish Health Survey Publications. http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/scottish-healthsurvey/Publications. Accessed Nov 2007
- 26.Manson JE, Greenland P, LaCroix AZ, Stefanick ML, Mouton CP, Oberman A, Perri MG, Sheps DS, Pettinger MB, Siscovick DS (2002) Walking compared with vigorous exercise for the prevention of cardiovascular events in women. N Engl J Med 347:716–725. doi: 10.1056/NEJMoa021067 PubMedCrossRefGoogle Scholar
- 31.Campbell KL, McTiernan A, Li SS, Sorensen BE, Yasui Y, Lampe JW, King IB, Ulrich CM, Rudolph RE, Irwin ML, Surawicz C, Ayub K, Potter JD, Lampe PD (2007) Effect of a 12-month exercise intervention on the apoptotic regulating proteins Bax and Bcl-2 in colon crypts: a randomized controlled trial. Cancer Epidemiol Biomarkers Prev 16:1767–1774. doi: 10.1158/1055-9965.EPI-07-0291 PubMedCrossRefGoogle Scholar