BackgroundDue to the increasing number of long-term (≥5 years post diagnosis) colorectal cancer survivors, long-term quality of life of these patients is highly relevant. Several studies have reported a positive association between physical activity and quality of life in colorectal cancer survivors, however, so far no systematic review has been published which focuses on long-term colorectal cancer survivors.Material and methodsA systematic review was conducted using the databases PubMed, Web of Science, PsychINFO, and CINAHL. Studies which investigated associations between physical activity and quality of life in long-term colorectal cancer survivors were included.Results and conclusionTen articles based on seven studies were identified. Long-term colorectal cancer survivors who were physically active reported better quality of life than long-term survivors who were not physically active. Both, moderate to vigorous physical activity and lower levels like light physical activity were associated with higher quality of life. Most studies assessed the association between physical activity and quality of life cross-sectionally but one prospective study which measured physical activity and quality of life at three different points in time also found associations between physical activity and quality of life. The association between physical activity and quality of life seemed to be stronger among women than among men. The findings of this systematic review support an association between physical activity and quality of life in long-term colorectal cancer survivors. However, the evidence is limited as most studies were based on cross-sectional and observational design.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-0934-7) contains supplementary material, which is available to authorized users.

Addressing barriers for PA might help to develop specific, individually tailored PA interventions to overcome PIA and improve the long-term outcome of CRC survivors.

Background: Evidence suggests that physical activity (PA) is beneficial for reducing fatigue in colorectal cancer (CRC) survivors. However, little is known regarding long-term effects of PA on fatigue and whether pre-diagnosis PA is associated with less fatigue in the years after diagnosis. Our study aimed to investigate the association of preand post-diagnosis PA with long-term fatigue in CRC survivors. Methods: This study used a German population-based cohort of 1781 individuals, diagnosed with CRC in 2003-2014, and alive at five-year follow-up (5YFU). Physical activity was assessed at diagnosis and at 5YFU. Fatigue was assessed by the Fatigue Assessment Questionnaire and the EORTC Quality of Life Questionnaire-Core 30 fatigue subscale at 5YFU. Multivariable linear regression was used to explore associations between pre-and post-diagnosis PA and fatigue at 5YFU. Results: No evidence was found that pre-diagnosis PA was associated with less fatigue in long-term CRC survivors. Pre-diagnosis work-related PA and vigorous PA were even associated with higher levels of physical (Beta (ß) = 2.52, 95% confidence interval (CI) = 1.14-3.90; ß = 2.03, CI = 0.65-3.41), cognitive (ß = 0.17, CI = 0.05-0.28; ß = 0.13, CI = 0.01-0.25), and affective fatigue (ß = 0.26, CI = 0.07-0.46; ß = 0.21, CI = 0.02-0.40). In cross-sectional analyses, postdiagnosis PA was strongly associated with lower fatigue on all scales. Conclusions: In this study, pre-diagnosis PA does not appear to be associated with less fatigue among long-term CRC survivors. Our results support the importance of ongoing PA in long-term CRC survivors. Our findings might be used as a basis for further research on specific PA interventions to improve the long-term outcome of CRC survivors.

Evidence suggests that physical activity (PA) is positively associated with (health-related) quality of life (QOL) in colorectal cancer (CRC) survivors. However, little is known regarding long-term effects of PA on QOL and if pre-diagnosis PA is associated with QOL in the years after diagnosis. Our study aimed to investigate the association of pre-and post-diagnosis PA with long-term QOL in CRC survivors.This study is based on a population-based cohort from Germany of 1781 newly diagnosed CRC survivors over a five-year period. Physical activity was assessed at diagnosis and at five-year follow up (5YFU). Quality of life was assessed by the EORTC Quality of Life Questionnaire-Core 30 at 5YFU. Multivariable linear regression was used to explore associations between pre-and post-diagnosis PA and QOL at 5YFU.No evidence of a positive association between higher levels of pre-diagnosis PA and better long-term QOL was found. Higher levels of pre-diagnosis work-related PA and vigorous PA were even associated with decreased QOL in domains such as cognitive (Beta(ß) = -2.52, 95% confidence interval(CI) =−3.77,-1.27; ß=-1.92, CI=-3.17,-0.67) and emotional functioning (ß=-2.52, CI=−3.84,-1.19; ß=-2.12, CI=-3.44,-0.80). In cross-sectional analyses, higher post-diagnosis PA was strongly associated with higher QOL. Survivors physically active at both pre-and post-diagnosis as well as survivors who increased their PA between pre-and post-diagnosis reported significantly higher long-term QOL compared to survivors who remained inactive at pre-and post-diagnosis.In this study, higher pre-diagnosis PA does not appear to be associated with higher QOL among long-term CRC survivors but our results support the importance of ongoing PA throughout survivorship.