Physical activity patterns after diagnosis and survival of prognostic colorectal cancer subgroups
Year: 2025
Type: article
Abstract: BACKGROUND: Physical activity (PA) is associated with improved overall survival (OS) among colorectal cancer (CRC) patients, but research on PA changes after diagnosis remains limited. This study examines associations between OS and changes in PA from CRC diagnosis onward, across stage- and treatment-related subgroups. METHODS: Data were analyzed from patients in two large CRC cohorts (PLCRC and COLON) enrolled between August 2010 and December 2022 (follow-up until February 1st, 2024). This included 3395 stage I-IIA patients who underwent surgery only, 2406 stage IIB/C-III patients who received (neo-)adjuvant therapy, and 669 metastatic CRC (mCRC) patients. PA was assessed via the validated SQUASH questionnaire at diagnosis (T0), and at 6, 12, and 24 months post-diagnosis (T6 to T24). Moderate-to-vigorous-intensity recreational activity was quantified by calculating Metabolic Equivalent of Task (MET) hours per week. Associations with OS were examined for change (active [tertile 2 and 3] vs inactive [tertile 1]) between timepoints using multivariable Cox proportional hazards models. RESULTS: Among surgery-only patients, change from inactivity to activity between T0 and T6 was significantly associated with OS (HR = 0.58, 95% CI = 0.35 to 0.96). For (neo-)adjuvantly treated patients, significant associations were observed between T6 and T12 (HR = 0.53, 95% CI = 0.31 to 0.90). Among mCRC patients, a significant association was observed between T6 and T12 (HR = 0.53, 95% CI = 0.29 to 0.99). CONCLUSION: Changing from inactivity to activity is significantly associated with prolonged survival during the early months post-diagnosis for surgery-only CRC patients, and later for those undergoing (neo-)adjuvant therapy or with metastatic disease. Validation is warranted in interventional studies.
Source: JNCI Cancer Spectrum
Authors: Karel C Smit, Jeroen W G Derksen, Anne-Sophie van Lanen, Evertine Wesselink, Eric J Th Belt, Maaike Berbée, Marissa Cloos-van Balen, Jan Willem T Dekker, Joyce M van Dodewaard, Joeri Douma, Jan Willem de Groot, Henk K Van Halteren, Mathijs P Hendriks, Ignace H J T De Hingh, Danny Houtsma, Johan J B Janssen, Joop L M Konsten, Maartje Los, Mark P S Sie, Dirkje Sommeijer, Pieter J Tanis, Ankie van der Velden, Liselot Valkenburg-van Iersel, Wouter J Vles, Johannes H W de Wilt, Dieuwertje E Kok, Ellen Kampman, Fränzel J B van Duijnhoven, Miriam Koopman, Anne M May
Institutions: Utrecht University, University Medical Center Utrecht, Wageningen University & Research, Albert Schweitzer Ziekenhuis, Maastricht University Medical Centre, Groene Hart Ziekenhuis, Reinier de Graaf Hospital, Meander Medisch Centrum, Medisch Centrum Leeuwarden, Isala, Admiraal De Ruyter Ziekenhuis, Noordwest Ziekenhuisgroep, Catharina Ziekenhuis, Haga Hospital, Canisius-Wilhelmina Ziekenhuis, VieCuri Medisch Centrum, St. Antonius Ziekenhuis, ZorgSaam, Flevoziekenhuis, Erasmus MC, Erasmus MC Cancer Institute, Tergooi, Maastricht University, Ikazia Ziekenhuis, Radboud University Nijmegen, Radboud University Medical Center
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,050
Funders: Bristol-Myers Squibb, Eli Lilly and Company, World Cancer Research Fund International, Haaglanden Medisch Centrum, Universiteit Leiden, ZonMw, Radboud Universiteit, Universiteit Maastricht, Maastricht Universitair Medisch Centrum, Leids Universitair Medisch Centrum, Radboud Universitair Medisch Centrum, Maag Lever Darm Stichting, Servier, Wereld Kanker Onderzoek Fonds, Dutch Colorectal Cancer Group, Stand Up To Cancer, World Cancer Research Fund
OpenAlex ID: W4417416955