Skip to main content

Advertisement

Log in

Physical activity and health-related quality of life in young adult cancer survivors: a Canadian provincial survey

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Objectives

Physical activity (PA) improves health-related quality of life (HRQL) in several cancer survivor groups but no studies have focused on young adult cancer survivors (YACS). This study determined the prevalence of PA in YACS and examined dose-response associations with HRQL.

Methods

A random sample of 2,000 YACS between the ages of 20–44 were identified through a Canadian provincial cancer registry and mailed a survey that included the Leisure-Time Exercise Questionnaire, the Medical Outcomes Study 36-Item Short Form (SF36) survey, and several validated psychosocial scales. The primary endpoint was the physical component summary (PCS) of the SF36.

Results

Completed questionnaires were received from 588 YACS. In terms of PA prevalence, 23% were completely sedentary, 25% were insufficiently active, 22% were active within public health guidelines, and 29% were active above public health guidelines. Analysis of covariance adjusted for important medical and demographic covariates showed a statistically significant and clinically meaningful dose-response association between PA and the PCS that spanned 6.3 points (95% confidence interval [CI] 3.7 to 8.8; p < 0.001) from completely sedentary to within guidelines. Similar associations were found for the mental component summary scale (p = 0.002), depression (p < 0.001), stress (p < 0.001) and self-esteem (p < 0.001). Associations between PA and HRQL were stronger for YACS that had previously received chemotherapy.

Conclusions

PA is strongly associated with HRQL in YACS but only half of YACS are meeting public health guidelines and almost a quarter are completely sedentary. Randomized controlled trials examining intervention strategies to increase PA and improve health outcomes in this understudied patient population are warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Theis B, Nishri, D, Balh S, Ugnat A-M, Marrett L, Cancer in young adults in Canada. Toronto: Cancer Care Ontario; 2006. ISBN 0-921325-10-X.

  2. Ries LAG, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Horner MJ, Mariotto A, Miller BA, Feuer EJ, Altekruse SF, Lewis DR, Clegg L, Eisner MP, Reichman M, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2005, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2005/, based on November 2007 SEER data submission, posted to the SEER web site, 2008.

    Google Scholar 

  3. Marrett LD, Frood J, Nishri D, Ugnat A, The Cancer in Young Adults in Canada (CYAC) Working Group. Cancer incidence in young adults in Canada: preliminary results of a cancer surveillance project. Chron Dis Can. 2002;23(2):58–64.

    Google Scholar 

  4. Burke ME, Albritton, K, Marina, N. Challenges in the recruitment of adolescents and young adults to cancer clinical trials. Cancer, 2007;110(11): 2385–2393.

    Google Scholar 

  5. Bleyer A. Cancer in older adolescents and young adults: epidemiology, diagnosis, treatment, survival and importance of clinical trials. Med Pediatr Oncol. 2006;38:1–10.

    Article  Google Scholar 

  6. Soliman H, Agresta SV. Current issues in adolescent and young adult cancer survivorship. Cancer Control. 2008;15(1):55–62.

    PubMed  Google Scholar 

  7. Bleyer A. Young adult oncology: the patients and their survival challenges. CA Cancer J Clin. 2007;57(4):242–55.

    Article  PubMed  Google Scholar 

  8. Shaw PH, Ritchey AK. Different rates of clinical trial enrollment between adolescents and young adults ages 15–22 years old and children under 15 with cancer at a children’s hospital. J Pediatr Hematol/Oncol. 2007;29(12):811–4.

    Article  Google Scholar 

  9. Schmitz KH, Holtzman J, Courneya KS, Masse LC, Duval S, Kane R. Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev. 2005;14(7):1588–95.

    Article  Google Scholar 

  10. McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS. Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. Can Med Assoc J. 2006;175(1):34–41.

    Article  Google Scholar 

  11. Thorsen L, Courneya KS, Stevinson C, Fossa SD. A systematic review of physical activity in prostate cancer survivors: outcomes, prevalence, and determinants. Support Care Cancer. 2008;16(9):987–97.

    Article  PubMed  Google Scholar 

  12. Liu RDKS, Chinapaw MJM, Huijgen PC, van Mechelen W. Physical exercise interventions in haematological cancer patients, feasible to conduct but effectiveness to be established: a systematic review. Cancer Treat Rev. 2008;35(2):185–92.

    Article  CAS  PubMed  Google Scholar 

  13. Lowe SS, Watanabe SM, Courneya KS. Physical activity as a supportive care intervention in palliative cancer patient: a systematic review. J Support Oncol. 2009;7(1):27–34.

    PubMed  Google Scholar 

  14. Courneya KS, Vallance JKH, McNeely M, Karvinen KH, Peddle CJ, Mackey JR. Exercise issues in older cancer survivors. Crit Rev Oncol/Hematol. 2004;51:249–61.

    Article  Google Scholar 

  15. Pakilit A, Kahn BA, Petersen MS, Abraham LS. Making effective use of tumor registries for cancer survivorship research. Cancer 2001;92(5):1305–14.

    Article  CAS  PubMed  Google Scholar 

  16. Vallance JKH, Courneya KS, Jones LW, Reiman T. Differences in quality of life between non-hodgkin’s lymphoma survivors meeting and not meeting public health exercise guidelines. Psycho Oncol. 2005;14:979–91.

    Article  Google Scholar 

  17. Stevinson C, Faught W, Steed H, Tonkin K, Ladha AB, Vallance JK, et al. Associations between physical activity and quality of life in ovarian cancer suvivors. Gynecol Oncol. 2007;106(1):244–50.

    Article  PubMed  Google Scholar 

  18. Peddle CJ, Plotnikoff RC, Wild C, Au H-J, Courneya KS. Medical, demographic, and pscyhosocial correlates of exercise in colorectal cancer survivors: an application of self determination theory. Support Care Cancer. 2007;16(1):9–17.

    Article  PubMed  Google Scholar 

  19. Karinen KH, Courneya KS, North S, Venner P. Associations between exercise and quality of life in badder cancer survivors: a population-based study. Cancer Epidemiol Biomark Prev. 2007;16:984–90.

    Article  Google Scholar 

  20. Dillman DA. Mail and telephone surveys- the total design method. New York; Wiley; 1978. 375 pp.

    Google Scholar 

  21. Godin G, Jobin J, Bouillon J. Assessment of leisure time exercise behaviour by self report: a concurrent validity study. Can J Public Health. 1986;77(5):359–62.

    CAS  PubMed  Google Scholar 

  22. Okun M, Karoly P, Lutz R. Clarifying the contribution of subjective norm to predicting leisure-time exercise. Am J Health Behav. 2002;26(4):296–305.

    PubMed  Google Scholar 

  23. Goldberg DP, Rickels K, Downing R, Hesbacher P. A comparison of two psychiatric screening tests. Br J Psychol. 1976;129:61–7.

    Article  CAS  Google Scholar 

  24. US Department of Health and Human Services (USDHHS). 2008 Physical Activity Guidelines for Americans. Washington, DC: USDHHS; http://www.health.gov/paguidelines/default/aspx. Accessed December 4, 2008.

  25. Ware J, Snow KK, Kosisnki M, Gandek B. SF-36 health survey: manual and interpretation guide. Boston: The Health Institite, New England Medical Center; 1993.

    Google Scholar 

  26. Ware J, Kosisnki M. Physical and mental health summary scales: a manual for users of version 1 (2nd Edition). Lincoln, RI: QualityMetric, 2001.

    Google Scholar 

  27. Pinar R. Reliability and construct validity pf the SF 36 in Turkish cancer patients. Qual Life Res. 2004;14(1):259–64.

    Article  Google Scholar 

  28. Cohen S, Kamarck T, Mermelstein R. A global measure of stress. J Health Soc Behav. 1983;24(4):385–96.

    Article  CAS  PubMed  Google Scholar 

  29. Reis RS, Hino A, Anez CR. Perceived stress scale: reliability and validity study in Brazil. J Health Psychol. 2010;15(1):107–14.

    Article  PubMed  Google Scholar 

  30. Rosenburg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press; 1965, 326 pp

    Google Scholar 

  31. Robins R, Hendin HM, Trzesniewski KH. Measuring global self-esteem: construct vlidation of single-item measure and the Rosenburg self esteem scale. Pers Soc Psychol Bull. 2001;27:151.

    Article  Google Scholar 

  32. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77–84.

    CAS  PubMed  Google Scholar 

  33. Hann D, Winter K, Jacobsen P. Measurement of depressive symptoms in cancer patients: evaluation of the centre for epidemilogical studies depression (CES-D). J Psychosom Res. 1999;46(5):437–43.

    Article  CAS  PubMed  Google Scholar 

  34. Loitz C, Berry TR, Spence JC. 2009 Alberta survey on physical activity: a concise report, Active Centre for Active Living; 2009 http://www.centre4activeliving.ca/publications/ab-survey-physical-activity/2009-report.pdf.

  35. Coups EJ, Ostroff JS. A population-based estimate of the prevalence of behavioural risk factors among adult cancer survivors and noncancer controls. Prev Med. 2004;40:702–11.

    Article  Google Scholar 

  36. Bellizzi KM, Rowland JH, Jeffery DD, McNeel T. Health behaviours of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol. 2005;23(34):8884–93.

    Article  PubMed  Google Scholar 

  37. Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors. J Clin Oncol. 2003;21(9):1660–8.

    Article  PubMed  Google Scholar 

  38. Courneya KS, Friedenreich CM, Sela RA, Quinney HA, Rhodes R, Handman M. The group pscyhotherapy and home-based physical exercise (group-hope) trial in cancer survivors: physical fitness and quality of life outcomes. Psycho Oncol. 2003;12(4):357–74.

    Article  Google Scholar 

  39. Young E, Korszun A. Sex, trauma, stress hormones and depression. Mol. Psychiatry. 2010;15(1):23–28.

    Google Scholar 

  40. Bhatia SC, Bhatia SK. Depression in women: diagnostic and treatment considerations. Am Fam Physician. 1999;60(1):225–34.

    CAS  PubMed  Google Scholar 

  41. Salmon P. Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clin Psychol Rev. 2001;21(1):33–61.

    Article  CAS  PubMed  Google Scholar 

  42. Youngstedt SD. Effects of exercise on sleep. Clin Sports Med. 2005;24(2):355–65.

    Article  PubMed  Google Scholar 

  43. Blair SN. Evidence for success of exercise in weight loss and control. Ann Intern Med. 1993;119(7):702–6.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kerry S. Courneya.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bélanger, L.J., Plotnikoff, R.C., Clark, A. et al. Physical activity and health-related quality of life in young adult cancer survivors: a Canadian provincial survey. J Cancer Surviv 5, 44–53 (2011). https://doi.org/10.1007/s11764-010-0146-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-010-0146-6

Keywords

Navigation