Moving through cancer: Setting the agenda to make exercise standard in oncology practice

Schmitz, Kathryn H.; Stout, Nicole L.; Maitin-Shepard, Melissa; Campbell, Anna; Schwartz, Anna L.; Grimmett, Chloe; Meyerhardt, Jeffrey A.; Sokolof, Jonas

doi:10.1002/cncr.33245

Cited by 56 publications

(63 citation statements)

References 27 publications

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“…Creating landscapes that promote exercise and active transport such as biking and walking is particularly important to cancer patients. Many clinical trials have shown the positive effects that walking and physical activity can have on quality of life and survival time in cancer patients [ 90 ], and are known to reduce risk of colorectal cancer development [ 91 , 92 ].…”

Section: Discussionmentioning

confidence: 99%

Measuring Neighborhood Landscapes: Associations between a Neighborhood’s Landscape Characteristics and Colon Cancer Survival

Wiese

Stroup

Maiti

et al. 2021

IJERPH

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Landscape characteristics have been shown to influence health outcomes, but few studies have examined their relationship with cancer survival. We used data from the National Land Cover Database to examine associations between regional-stage colon cancer survival and 27 different landscape metrics. The study population included all adult New Jersey residents diagnosed between 2006 and 2011. Cases were followed until 31 December 2016 (N = 3949). Patient data were derived from the New Jersey State Cancer Registry and were linked to LexisNexis to obtain residential histories. Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI95) for the different landscape metrics. An increasing proportion of high-intensity developed lands with 80–100% impervious surfaces per cell/pixel was significantly associated with the risk of colon cancer death (HR = 1.006; CI95 = 1.002–1.01) after controlling for neighborhood poverty and other individual-level factors. In contrast, an increase in the aggregation and connectivity of vegetation-dominated low-intensity developed lands with 20–<40% impervious surfaces per cell/pixel was significantly associated with the decrease in risk of death from colon cancer (HR = 0.996; CI95 = 0.992–0.999). Reducing impervious surfaces in residential areas may increase the aesthetic value and provide conditions more advantageous to a healthy lifestyle, such as walking. Further research is needed to understand how these landscape characteristics impact survival.

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Section: Discussionmentioning

confidence: 99%

Measuring Neighborhood Landscapes: Associations between a Neighborhood’s Landscape Characteristics and Colon Cancer Survival

Wiese

Stroup

Maiti

et al. 2021

IJERPH

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“…Hundreds of randomized controlled trials (RCTs) examining the feasibility, safety, efficacy, or effectiveness of exercise interventions before, during, and after active oncology treatment across different cancer types have contributed to an ever-growing multitude of systematic reviews and meta-analyses, which in turn have been synthesized in umbrella reviews (2, 3). Such evidence now underpins clinical exercise guideline recommendations, including specific exercise prescriptions for some cancer-related health outcomes (4, 5) and appeals for exercise to be viewed as standard practice in oncology (6, 7).…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, many effects within these meta-analyses may be vulnerable to selective (non-) reporting bias, which could change the direction, size, and certainty of pooled effect estimates. The existence of selective (non-) reporting in exercise oncology trials risks undermining exercise-based clinical guidelines and calls to include exercise in the standard care of patients with cancer (6). To date, however, selective (non-) reporting biases have not been assessed in RCTs of exercise interventions for people diagnosed with cancer.…”

Section: Introductionmentioning

confidence: 99%

Outcome Reporting bias in Exercise Oncology trials (OREO): a cross-sectional study

Singh

Fairman

Christensen

et al. 2021

Preprint

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Background: Despite evidence of selective outcome reporting across multiple disciplines, this has not yet been assessed in trials studying the effects of exercise in people with cancer. Therefore, the purpose of our study was to explore prospectively registered randomised controlled trials (RCTs) in exercise oncology for evidence of selective outcome reporting. Methods: Eligible trials were RCTs that 1) investigated the effects of at least partially supervised exercise interventions in people with cancer; 2) were preregistered (i.e. registered before the first patient was recruited) on a clinical trials registry; and 3) reported results in a peer-reviewed published manuscript. We searched the PubMed database from the year of inception to September 2020 to identify eligible exercise oncology RCTs clinical trial registries. Eligible trial registrations and linked published manuscripts were compared to identify the proportion of sufficiently preregistered outcomes reported correctly in the manuscripts, and cases of outcome omission, switching, and silently introduction of non- novel outcomes. Results: We identified 31 eligible RCTs and 46 that were ineligible due to retrospective registration. Of the 405 total prespecified outcomes across the 31 eligible trials, only 6.2% were preregistered complete methodological detail. Only 16% (n=148/929) of outcomes reported in published results manuscripts were linked with sufficiently preregistered outcomes without outcome switching. We found 85 total cases of outcome switching. A high proportion (41%) of preregistered outcomes were omitted from the published results manuscripts, and many published outcomes (n=394; 42.4%) were novel outcomes that had been silently introduced (median, min-max=10, 0-50 per trial). We found no examples of preregistered efficacy outcomes that were measured, assessed, and analysed as planned. Conclusions: We found evidence suggestive of widespread selective outcome reporting and non-reporting bias (omitted preregistered outcomes, outcome switching, and silently introduced novel outcomes). The existence of such reporting discrepancies has implications for the integrity and credibility of RCTs in exercise oncology.

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“…The ACSM recently proposed the 'Moving Through Cancer' initiative to increase the proportion of cancer survivors who are physically active [7,8]. This involves healthcare professionals assessing, advising, and referring patients to exercise services.…”

Section: Introductionmentioning

confidence: 99%

Recall, perceptions and determinants of receiving physical activity advice amongst cancer survivors: a mixed-methods survey

Orange

Gilbert

Brown

et al. 2021

Support Care Cancer

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Purpose This study explored cancer survivors’ views and experiences of receiving physical activity advice post-diagnosis. We also determined the influence of sociodemographic characteristics on the recall of physical activity advice and whether receiving advice was associated with meeting physical activity guidelines. Methods An anonymised, mixed-methods, 27-item survey was distributed to cancer survivors via online cancer communities in the UK. Results Of the 242 respondents, 52% recalled receiving physical activity advice. Of those who recalled receiving advice, only 30% received guidance on type of physical activity and 14% were referred to another source of information or exercise specialist. Advice was most often given after treatment cessation, with only 19% of respondents receiving advice during active treatment. Most respondents (56%) expressed a need for further information. There was no evidence of associations between sociodemographic characteristics and recall of physical activity advice. However, cancer survivors who perceived the physical activity advice they received as being appropriate (odds ratio [OR] 3.8, 95% confidence interval [95% CI]: 1.4–10.7) and those with a higher level of education (OR 3.2, 95% CI: 1.8–5.8) were more likely to meet aerobic exercise guidelines. Females were less likely to meet resistance exercise guidelines than males (OR 0.44, 95% CI: 0.21–0.90). Conclusion There is scope to improve the provision of physical activity advice in cancer care by providing advice in a timely manner after diagnosis, referring patients to a suitable exercise or rehabilitation specialist when indicated, and using a tailored approach to ensure the advice is appropriate for specific sociodemographic groups.

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Moving through cancer: Setting the agenda to make exercise standard in oncology practice

Cited by 56 publications

References 27 publications

Measuring Neighborhood Landscapes: Associations between a Neighborhood’s Landscape Characteristics and Colon Cancer Survival

Measuring Neighborhood Landscapes: Associations between a Neighborhood’s Landscape Characteristics and Colon Cancer Survival

Outcome Reporting bias in Exercise Oncology trials (OREO): a cross-sectional study

Recall, perceptions and determinants of receiving physical activity advice amongst cancer survivors: a mixed-methods survey

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