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Leisure-time physical activity, daily sitting time, and mortality among US skin cancer survivors

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Abstract

Purpose

To investigate the long-term effect of sitting time and physical activity after a skin cancer diagnosis.

Methods

A cohort of a nationally representative sample of skin cancer survivors (n=862) and non-cancer adults (n=13691) ≥50 years from the US National Health and Nutrition Examination Survey. Mortality data were linked through December 31, 2019.

Results

During up to 13.2 years of follow-up (median, 6.3 years; 94,093 person-years), 207 deaths (cancer: 53) occurred in skin cancer survivors and 1970 (cancer: 414) in non-cancer adults. After adjusting for covariates and skin cancer type, being active was associated with lower risks of all-cause (HR=0.69; 95% CI: 0.47 to 1.00) and non-cancer (HR=0.59; 95% CI: 0.36 to 0.97) mortality compared to being inactive among skin cancer survivors. Meanwhile, sitting 8 h/d was associated with higher risks of all-cause (HR=1.72; 95% CI: 1.11 to 2.67) and non-cancer (HR=1.76; 95% CI: 1.07 to 2.92) mortality compared to sitting <6 h/d. In the joint analysis, inactive skin cancer survivors sitting >8 h/d had the highest mortality risks from all-cause (HR=2.26; 95% CI: 1.28 to 4.00) and non-cancer (HR=2.11; 95% CI,1.10 to 4.17). Additionally, the associations of LTPA and sitting time with all-cause and cause-specific mortality did not differ between skin cancer survivors and non-cancer adults (all P for interaction>0.05)

Conclusion

The combination of prolonged sitting and lack of physical activity was associated with elevated risks of all-cause and non-cancer deaths among US skin cancer survivors. Skin cancer survivors could benefit from maintaining a physically active lifestyle.

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Data availability

The data underlying this article are availably publicly through https://www.cdc.gov/nchs/nhanes/index.htm

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Funding

Chao Cao is supported by the U.S. National Cancer Institute grant 5T32CA092203

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA

    Chao Cao

  2. Department of Public Health Sciences, University of California, Davis, Davis, CA, USA

    Nan Wang

  3. San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, USA

    Raymond Liu

  4. Department of Population Science, American Cancer Society, Kennesaw, GA, USA

    Alpa V. Patel

  5. Department of Cancer Epidemiology and Prevention Research, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada

    Christine M. Friedenreich & Lin Yang

  6. Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

    Christine M. Friedenreich & Lin Yang

Authors
  1. Chao Cao
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  2. Nan Wang
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  3. Raymond Liu
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  4. Alpa V. Patel
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  5. Christine M. Friedenreich
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  6. Lin Yang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Chao Cao, Nan Wang, Raymond Liu, Alpa V. Patel, Christine M. Friedenreich, and Lin Yang. The first draft of the manuscript was written by Chao Cao and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Chao Cao.

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This study involves secondary data analysis utilizing unidentified data, obviating the need for IRB approval.

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The authors declare no competing interests.

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Cao, C., Wang, N., Liu, R. et al. Leisure-time physical activity, daily sitting time, and mortality among US skin cancer survivors. Support Care Cancer 31, 718 (2023). https://doi.org/10.1007/s00520-023-08192-6

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