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Rethinking physical activity assessment in cancer survivors: a multi-component approach using NHANES data

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Abstract

Purpose

To confirm that a multi-component physical activity index (PAI), with physical activity (PA)–related behaviors and performance measures, enhances PA assessment for adults with cancer history (“survivors”) vs. for the general population for key health variables.

Methods

Data from 2011 to 2014 NHANES were analyzed (n = 9620 adults, including 866 survivors). We generated PAI scores by calculating subscales for activity-related behaviors (i.e., moderate-to-vigorous PA and TV viewing hours/sedentary time) (n/8) and performance (i.e., cardiorespiratory fitness and muscle strength) (n/8), then combined for an overall PAI score (n/16 points). Dependent variables (self-reported health, multimorbidity, and functional limitations) were dichotomized and tested with logistic regression to estimate associations with PAI variables.

Results

Survivors obtaining 22.5 + MET hours/week of PA were >5× more likely to report excellent health than non-exercisers (OR = 5.5, 95% CI 3.27–9.28). We observed a general decrease in likelihood of multimorbidity and functional limitations with increasing PA. Models with the combined score showed that higher PAI scores had larger positive associations with all three for all adults. Survivors with higher PAI scores were >30% more likely to report excellent self-rated health (OR = 1.3, 95% CI 1.2–1.4) and 20% less likely to report multimorbidity and functional limitations compared to survivors with lower PAI scores, considering covariates.

Conclusions

Greater PA-related behavior and performance was beneficial for adults irrespective of cancer history. However, using a combined score elucidates unique needs and benefits for survivors vs. for general population.

Implications for Cancer Survivors

Using a multi-component approach to PA assessment could help in developing validated tools to plan exercise programs and interventions for survivors.

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Funding

This project was originally supported by the Intramural Trans-Fellowship Research Award through the Division of Cancer Prevention at the National Cancer Institute, part of the National Institutes of Health (NIH) (PIs: Bluethmann and Keadle). Matthews is supported through the Intramural Research Program at the National Cancer Institute. Bluethmann is currently supported by a Mentored Research Scholar Grant in Applied and Clinical Research, MSRG-18-136-01-CPPB, from the American Cancer Society (ACS). King is supported through the Penn State CTSI (NIH UL1-TR002014).

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Authors and Affiliations

  1. Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Suite T3424, Hershey, PA, USA

    Shirley M. Bluethmann & Tonya S. King

  2. Penn State Cancer Institute, Hershey, PA, USA

    Shirley M. Bluethmann

  3. Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, USA

    Sarah K. Keadle

  4. Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, The National Cancer Institute, Bethesda, MD, USA

    Charles E. Matthews

  5. Behavioral Research Program, Division of Cancer Control and Population Sciences, The National Cancer Institute, Bethesda, MD, USA

    Frank M. Perna

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  1. Shirley M. Bluethmann
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Correspondence to Shirley M. Bluethmann.

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Bluethmann, S.M., Keadle, S.K., King, T.S. et al. Rethinking physical activity assessment in cancer survivors: a multi-component approach using NHANES data. J Cancer Surviv 16, 781–790 (2022). https://doi.org/10.1007/s11764-021-01072-0

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