Cancer Causes & Control

, Volume 23, Issue 12, pp 1939–1948 | Cite as

Recreational physical activity, body mass index, and survival in women with colorectal cancer

  • Josephina G. Kuiper
  • Amanda I. PhippsEmail author
  • Marian L. Neuhouser
  • Rowan T. Chlebowski
  • Cynthia A. Thomson
  • Melinda L. Irwin
  • Dorothy S. Lane
  • Jean Wactawski-Wende
  • Lifang Hou
  • Rebecca D. Jackson
  • Ellen Kampman
  • Polly A. Newcomb
Original paper


Background and purpose

Previous studies have shown that physical inactivity and obesity are risk factors for the development of colorectal cancer. However, controversy exists regarding the influence of these factors on survival in colorectal cancer patients. We evaluated the impact of recreational physical activity and body mass index (BMI) before and after colorectal cancer diagnosis on disease-specific mortality and all-cause mortality.

Patients and methods

This prospective cohort study included 1,339 women enrolled in the Women’s Health Initiative study who were diagnosed with colorectal cancer subsequent to study enrollment. BMI and recreational physical activity were measured before cancer diagnosis at study entry (pre-diagnostic) and after diagnosis at study follow-up interviews (post-diagnostic). We used Cox regression to estimate the association between pre- and post-diagnostic exposures and survival after colorectal cancer diagnosis.


Among women diagnosed with colorectal cancer, 265 (13 %) deaths occurred during a median study follow-up of 11.9 years, of which 171 (65 %) were attributed to colorectal cancer. Compared with women reporting no pre-diagnostic recreational physical activity, those reporting activity levels of ≥18 MET-h/week had significantly lower colorectal cancer-specific mortality (hazard ratio (HR) = 0.68; 95 % confidence interval (CI): 0.41–1.13) and all-cause mortality (HR = 0.63; 95 % CI: 0.42–0.96). Similar inverse associations were seen for post-diagnostic recreational physical activity. Neither pre- nor post-diagnostic BMI were associated with mortality after colorectal cancer diagnosis.


Recreational physical activity before and after colorectal cancer diagnosis, but not BMI, is associated with more favorable survival.


Physical activity Body mass index Colorectal cancer Survival Post-menopausal 



This work was supported by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services (contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42107-26, 42129-32, and 44221). This publication was also supported by the National Cancer Institute (R25-CA94880 and K05152715).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Josephina G. Kuiper
    • 1
  • Amanda I. Phipps
    • 2
    Email author
  • Marian L. Neuhouser
    • 2
  • Rowan T. Chlebowski
    • 3
  • Cynthia A. Thomson
    • 4
  • Melinda L. Irwin
    • 5
  • Dorothy S. Lane
    • 6
  • Jean Wactawski-Wende
    • 7
  • Lifang Hou
    • 8
  • Rebecca D. Jackson
    • 9
  • Ellen Kampman
    • 1
    • 10
  • Polly A. Newcomb
    • 2
  1. 1.Division of Human NutritionWageningen UniversityWageningenThe Netherlands
  2. 2.Cancer Prevention Program, Public Health Sciences DivisionFred Hutchinson Cancer Research CenterSeattleUSA
  3. 3.Los Angeles Biomedical Research Institute Harbor-UCLA Medical CenterTorranceUSA
  4. 4.Department of Nutritional SciencesUniversity of ArizonaTucsonUSA
  5. 5.Yale School of Public HealthYale UniversityNew HavenUSA
  6. 6.Community and Behavioral Health FacultyStony Brook University Medical CenterStony BrookUSA
  7. 7.Department of Social and Preventive MedicineUniversity at BuffaloBuffaloUSA
  8. 8.Department of Preventive Medicine, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  9. 9.Division of Endocrinology, Diabetes and MetabolismOhio State UniversityColumbusUSA
  10. 10.Department of Health SciencesVU AmsterdamAmsterdamThe Netherlands

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