Skip to main content

How sedentary and physically active are breast cancer survivors, and which population subgroups have higher or lower levels of these behaviors?

Supportive Care in Cancer volume 24, pages 2181–2190 (2016)Cite this article

Abstract

Purpose

Physical activity (PA) and sedentary behavior may influence the physical and mental health of breast cancer survivors; however, few studies have objectively measured these behaviors in this population. We used accelerometers to measure the PA and sedentary time levels of breast cancer survivors and examined the demographic, behavioral, and medical correlates of these behaviors using two complementary approaches.

Methods

A total of 259 breast cancer survivors wore an accelerometer for 7 days during waking hours and completed a questionnaire. We used linear regression and classification trees to investigate correlates of PA and sedentary time.

Results

The breast cancer survivors in this study (mean age = 61 years, mean time since diagnosis = 3 years) were sedentary for a daily average of 8.2 h, in light-intensity PA for 5.8 h and in moderate-to-vigorous intensity PA (MVPA) for 32 min, with 16 % meeting PA guidelines. Participants with high comorbidity were the least likely to be meeting guidelines (0 %), while a subgroup of participants with no/low comorbidity, a university degree, and higher levels of pre-diagnosis MVPA were the most likely to be meeting guidelines (47 %). Older participants (70+ years) were the most likely to have sedentary time levels at least twice as high as activity levels, while participants who were younger than 70 years and not in the lowest category of pre-diagnosis MVPA were the least likely.

Conclusions

Interventions to facilitate physical activity and reduce sedentary time among breast cancer survivors should consider comorbidity status and previous PA experience.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Schmitz K (2011) Physical activity and breast cancer survivorship. In: Courneya KS, Friedenreich CM (eds) Physical activity and cancer. Springer, Berlin Heidelberg, pp 189–215

    Google Scholar 

  2. 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 25:1293–1311

    CAS  Article  PubMed  Google Scholar 

  3. Lynch BM, Dunstan DW, Vallance JK, Owen N (2013) Don’t take cancer sitting down. Cancer 119:1928–1935

    Article  PubMed  Google Scholar 

  4. Mason C, Alfano CM, Smith AW, Wang CY, Neuhouser ML, Duggan C, Bernstein L, Baumgartner KB, Baumgartner RN, Ballard-Barbash R, McTiernan A (2013) Long-term physical activity trends in breast cancer survivors. Cancer Epidemiol Biomarkers Prev 22:1153–1161

    Article  PubMed  PubMed Central  Google Scholar 

  5. Brunet J, Amireault S, Chaiton M, Sabiston CM (2014) Identification and prediction of physical activity trajectories in women treated for breast cancer. Ann Epidemiol 24:837–842

    Article  PubMed  Google Scholar 

  6. Hair BY, Hayes S, Tse C-K, Bell MB, Olshan AF (2014) Racial differences in physical activity among breast cancer survivors: implications for breast cancer care. Cancer 120:2174–2182

    Article  PubMed  PubMed Central  Google Scholar 

  7. Keegan TM, Shariff-Marco S, Sangaramoorthy M, Koo J, Hertz A, Schupp C, Yang J, John E, Gomez S (2014) Neighborhood influences on recreational physical activity and survival after breast cancer. Cancer Causes Control 25:1295–1308

    Article  PubMed  PubMed Central  Google Scholar 

  8. 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 26:2198–2204

    Article  PubMed  Google Scholar 

  9. Sabiston CM, Brunet J, Vallance JK, Meterissian S (2014) Prospective examination of objectively assessed physical activity and sedentary time after breast cancer treatment: sitting on the crest of the teachable moment. Cancer Epidemiol Biomarkers Prev 23:1324–1330

    CAS  Article  PubMed  Google Scholar 

  10. Phillips SM, Awick EA, Conroy DE, Pellegrini CA, Mailey EL, McAuley E (2015) Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer. Cancer. doi:10.1002/cncr.29620, Advance online publication

    Google Scholar 

  11. Boyle T, Lynch BM, Courneya KS, Vallance JK (2015) Agreement between accelerometer-assessed and self-reported physical activity and sedentary time in colon cancer survivors. Support Care Cancer 23:1121–1126

    Article  PubMed  Google Scholar 

  12. Lynch BM, Dunstan DW, Healy GN, Winkler E, Eakin E, Owen N (2010) Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: findings from NHANES (2003–2006). Cancer Causes Control 21:283–288

    Article  PubMed  Google Scholar 

  13. George SM, Alfano CM, Wilder Smith A, Irwin ML, McTiernan A, Bernstein L, Baumgartner KB, Ballard-Barbash R (2013) Sedentary behavior, health-related quality of life, and fatigue among breast cancer survivors. J Phys Act Health 10:350–358

    Article  PubMed  Google Scholar 

  14. Bock C, Schmidt ME, Vrieling A, Chang-Claude J, Steindorf K (2013) Walking, bicycling, and sports in postmenopausal breast cancer survivors—results from a German patient cohort study. Psychooncology 22:1291–1298

    Article  PubMed  Google Scholar 

  15. Lemon S, Roy J, Clark M, Friedmann P, Rakowski W (2003) Classification and regression tree analysis in public health: methodological review and comparison with logistic regression. Ann Behav Med 26:172–181

    Article  PubMed  Google Scholar 

  16. Frank LD, Kerr J, Sallis JF, Miles R, Chapman J (2008) A hierarchy of sociodemographic and environmental correlates of walking and obesity. Prev Med 47:172–178

    Article  PubMed  Google Scholar 

  17. Boslaugh SE, Kreuter MW, Nicholson RA, Naleid K (2005) Comparing demographic, health status and psychosocial strategies of audience segmentation to promote physical activity. Health Educ Res 20:430–438

    Article  PubMed  Google Scholar 

  18. Dominick G, Papas M, Rogers M, Rakowski W (2015) Classification tree analysis to examine influences on colorectal cancer screening. Cancer Causes Control 26:443–454

    Article  PubMed  Google Scholar 

  19. Ransom EK, Lynch BM, Vallance JK, Boyle T (2015) Offering personalized health behavior feedback did not increase response rate: a randomized controlled trial. J Clin Epidemiol 68:1383–1384

    Article  PubMed  Google Scholar 

  20. Fritschi L, Erren TC, Glass DC, Girschik J, Thomson AK, Saunders C, Boyle T, El-Zaemey S, Rogers P, Peters S, Slevin T, D’Orsogna A, de Vocht F, Vermeulen R, Heyworth JS (2013) The association between different night shiftwork factors and breast cancer: a case–control study. Br J Cancer 109:2472–2480

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  21. Freedson PS, Melanson E, Sirard J (1998) Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc 30:777–781

    CAS  Article  PubMed  Google Scholar 

  22. Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, Troiano RP (2008) Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol 167:875–881

    Article  PubMed  PubMed Central  Google Scholar 

  23. Dunstan DW, Kingwell BA, Larsen R, Healy GN, Cerin E, Hamilton MT, Shaw JE, Bertovic DA, Zimmet PZ, Salmon J, Owen N (2012) Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care 35:976–983

    Article  PubMed  PubMed Central  Google Scholar 

  24. Canadian Society for Exercise Physiology (2011) Canadian physical activity guidelines: 2011 scientific statements. Canadian Society for Exercise Physiology, Ottawa

    Google Scholar 

  25. Physical Activity Guidelines Advisory Committee (2008) Physical activity guidelines advisory committee report, 2008. U.S. Department of Health and Human Services, Washington, DC

    Google Scholar 

  26. Australian Bureau of Statistics (2013) Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2011. Catalogue Number 2033.0.55.001. Australian Bureau of Statistics, Canberra, Australia

  27. Boyle T, Heyworth J, Bull F, Fritschi L (2013) Test-retest reliability of transport-related physical activity performed over the lifetime. J Phys Act Health 10:626–631

    Article  PubMed  Google Scholar 

  28. Chasan-Taber L, Erickson JB, McBride JW, Nasca PC, Chasan-Taber S, Freedson PS (2002) Reproducibility of a self-administered lifetime physical activity questionnaire among female college alumnae. Am J Epidemiol 155:282–291

    Article  PubMed  Google Scholar 

  29. Horne JA, Östberg O (1977) Individual differences in human circadian rhythms. Biol Psychol 5:179–190

    CAS  Article  PubMed  Google Scholar 

  30. Kass GV (1980) An exploratory technique for investigating large quantities of categorical data. J R Stat Soc: Ser C: Appl Stat 29:119–127

    Google Scholar 

  31. Ramin C, Devore EE, Pierre-Paul J, Duffy JF, Hankinson SE, Schernhammer ES (2013) Chronotype and breast cancer risk in a cohort of U.S. nurses. Chronobiol Int 30:1181–1186

    Article  PubMed  PubMed Central  Google Scholar 

  32. Haraszti RÁ, Purebl G, Salavecz G, Poole L, Dockray S, Steptoe A (2014) Morningness–eveningness interferes with perceived health, physical activity, diet and stress levels in working women: a cross-sectional study. Chronobiol Int 31:829–837

    Article  PubMed  Google Scholar 

  33. Urban R, Magyarodi T, Rigo A (2011) Morningness-eveningness, chronotypes and health-impairing behaviors in adolescents. Chronobiol Int 28:238–247

    Article  PubMed  Google Scholar 

  34. Schaal S, Peter M, Randler C (2010) Morningness‐eveningness and physical activity in adolescents. International Journal of Sport and Exercise Psychology 8:147–159

    Article  Google Scholar 

  35. Roeser K, Obergfell F, Meule A, Vögele C, Schlarb AA, Kübler A (2012) Of larks and hearts—morningness/eveningness, heart rate variability and cardiovascular stress response at different times of day. Physiol Behav 106:151–157

    CAS  Article  PubMed  Google Scholar 

  36. Gaina A, Sekine M, Kanayama H, Takashi Y, Hu L, Sengoku K, Kagamimori S (2006) Morning‐evening preference: sleep pattern spectrum and lifestyle habits among Japanese junior high school pupils. Chronobiol Int 23:607–621

    Article  PubMed  Google Scholar 

  37. Kauderer S, Randler C (2012) Differences in time use among chronotypes in adolescents. Biol Rhythm Res 44:601–608

    Article  Google Scholar 

  38. Brown WJ, Mishra G, Lee C, Bauman A (2000) Leisure time physical activity in Australian women: relationship with well being and symptoms. Res Q Exerc Sport 71:206–216

    CAS  Article  PubMed  Google Scholar 

  39. Scharff DP, Homan S, Kreuter M, Brennan L (1999) Factors associated with physical activity in women across the life span: implications for program development. Women Health 29:115–134

    CAS  Article  PubMed  Google Scholar 

Download references

Acknowledgments

The ACCEL-Breast study was funded by a project grant from the Breast Cancer Research Centre—Western Australia. The case-control study (the Breast Cancer Environment and Employment Study) was funded by the Australian National Health and Medical Research Council (#573530). Terry Boyle is supported by an Early Career Fellowship from the Australian National Health and Medical Research Council (#1072266), a Fellowship from the Canadian Institutes of Health Research (#300068), a Postdoctoral Fellowship from the Michael Smith Foundation for Health Research (#5553), and an Honorary Killam Postdoctoral Research Fellowship from Killam Trusts/The University of British Columbia. Jeff Vallance is supported by the Canada Research Chairs program and a Population Health Investigator Award from Alberta Innovates—Health Solutions. Brigid Lynch is supported by an Early Career Fellowship from the National Breast Cancer Foundation. We would like to acknowledge the Chief Investigators of the case-control study (in particular Professor Lin Fritschi from the School of Public Health at Curtin University and Professor Jane Heyworth from the School of Population Health at The University of Western Australia), and Ms Jessica Occleston at the Baker IDI Heart and Diabetes Institute for her assistance in data processing. We also sincerely thank the people who took the time to participate in this study.

Author information

Affiliations

  1. Cancer Control Research, British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada

    Terry Boyle

  2. School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada

    Terry Boyle

  3. Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia

    Terry Boyle & Emily K. Ransom

  4. Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada

    Jeff K. Vallance

  5. Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia

    Brigid M. Lynch

  6. School of Population and Global Health, The University of Melbourne, Melbourne, Australia

    Brigid M. Lynch

  7. Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia

    Brigid M. Lynch

Authors
  1. Terry Boyle
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeff K. Vallance
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Emily K. Ransom
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brigid M. Lynch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Terry Boyle.

Ethics declarations

Conflict of interest

The authors declare they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Table 1

(DOCX 26 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Boyle, T., Vallance, J.K., Ransom, E.K. et al. How sedentary and physically active are breast cancer survivors, and which population subgroups have higher or lower levels of these behaviors?. Support Care Cancer 24, 2181–2190 (2016). https://doi.org/10.1007/s00520-015-3011-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-015-3011-3

Keywords

  • Cancer
  • Oncology
  • Survivorship
  • Breast cancer
  • Physical activity
  • Sedentary behavior