Determinants of changes in physical activity from pre-diagnosis to post-diagnosis in a cohort of prostate cancer survivors



Physical activity (PA) has been shown to improve quality of life and survival in cancer survivors; however, a cancer diagnosis may change PA patterns. We examine determinants of changes in meeting the PA guidelines (150 min/week of moderate aerobic PA) before and after a prostate cancer diagnosis.


Eight hundred and thirty prostate cancer survivors who participated in a population-based case–control study between 1997 and 2000 in Alberta, Canada, enrolled in a prospective cohort study. Past year activity levels were self-reported at diagnosis (pre-diagnosis measure) and again 2 years post-diagnosis. Determinants were collected by questionnaires and medical chart abstractions. Four PA patterns were created: non-exercisers (fail to meet guidelines pre-diagnosis and post-diagnosis), adopters (fail to meet guidelines pre-diagnosis, meet guidelines post-diagnosis), maintainers (meet guidelines pre-diagnosis and post-diagnosis) and relapsers (meet guidelines pre-diagnosis, fail to meet guidelines post-diagnosis).


Multinomial logistic regression analyses identified that being a non-exerciser compared to maintainer was associated with being employed, rural location, high PSA, smoking status, not attending support groups and less than average physical quality of life (QoL). Being a relapser compared to maintainer was associated with rural location and lack of friend support. Finally, being a non-exerciser compared to adopter was associated with urinary incontinence, smoking status and less than average physical and mental QoL.


Demographic, health and lifestyle variables are associated with changes in meeting PA guidelines from pre-diagnosis to post-diagnosis in prostate cancer survivors. Programming should be aimed at offering interventions to help inactive survivors adopt PA and active survivors to maintain PA.

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the Lifetime Total Physical Activity Questionnaire


metabolic equivalent of task


moderate vigorous physical activity

OR :

odds ratio


prostate-specific antigen

QoL :

quality of life


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Study coordination was done by Aleata Ryhorchuk and Sana Fakih. Interviewers for this study were Jodi Parrotta, Linda Davison, Pearl Cooke, Nicole Slot, Carol-Anne Zawalykut and Catherine Munro. Data entry was done by Carla Quesnel and chart abstraction by Yvonne LeBlanc and Sarah MacLaughlin. Steven J. Angyalfi provided clinical expertise regarding prostate cancer treatment and care.


Research relating to this manuscript was supported by the Canadian Institute of Health Research (2004–2007; grant number MOP-67217), the National Cancer Institute of Canada with funds from the Canadian Cancer Society (2000–2004; grant number 011004) and the Alberta Cancer Board-Research Initiative Program (2004–2007; grant number 4570). Christine M. Friedenreich held career awards from Alberta Innovates-Health Solutions and Alberta Cancer Foundation, Kerry S. Courneya was supported by the Canada Research Chairs Program and S. Elizabeth McGregor was supported by the Alberta Heritage Foundation for Medical Research.

Author information




K.S. C., S.E. M. and C.M. F. were involved in study conception and design. K.S.C., C.M. F. and C.R. S. acquired the data. C.R. S. completed statistical analyses and drafting of the manuscript. All authors critically revised the manuscript for intellectual content, approved the final version of the manuscript and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Christine M. Friedenreich.

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Ethics approval and consent to participate

The study protocol was approved by the Health Research Ethics Board of Alberta—Cancer Committee and the Conjoint Health Research Ethics Board at the University of Calgary. Informed consent was provided by all participants prior to study participation. 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.

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Stone, C.R., Courneya, K.S., McGregor, S.E. et al. Determinants of changes in physical activity from pre-diagnosis to post-diagnosis in a cohort of prostate cancer survivors. Support Care Cancer 27, 2819–2828 (2019).

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  • Exercise determinants
  • Physical activity
  • Guidelines
  • Prostate cancer
  • Correlates