Physical Activity after Colorectal Cancer Diagnosis and Mortality in a Nationwide Retrospective Cohort Study

Abstract

Physical activity reduces the risk of colon cancer, but its prognostic impact after cancer diagnosis remains unclear. To evaluate the association between post-diagnosis activity and cause-specific mortality, we reconstructed a colorectal cancer patient cohort from the 2009–16 Korean National Health Insurance Service (NHIS) database. Subgroup analyses were performed by treatment group. In total, 27,143 colon cancer patients and 16,453 rectal cancer patients were included in the analysis (mean follow-up, 4.3 years; median 4.0 years). In the surgically treated group, a high level of activity (the weighted sum of the frequencies for walking, moderate, and vigorous activity greater than or equal to 3 times/week) was inversely associated with all-cause mortality (colon cancer: HR, 0.79; 95% CI, 0.72 to 0.88; rectal cancer: HR, 0.75; 95% CI, 0.66 to 0.86) and colorectal cancer-specific mortality (colon cancer: HR, 0.85; 95% CI, 0.76 to 0.97; rectal cancer: HR, 0.77; 95% CI, 0.66 to 0.90). No significant results were shown for cardiovascular disease-specific mortality. No association was shown in patients who received chemoradiotherapy without surgery. The present study may provide evidence for post-diagnosis physical activity as a prognostic factor in colorectal cancer, particularly in surgically treated early-stage patients.

Baseline Quality of Life of Physical Function Is Highly Relevant for Overall Survival in Advanced Rectal Cancer

“…Numerous studies and meta-analyses have shown a positive correlation between physical activity and overall survival [ 4 , 5 , 6 , 7 , 8 , 11 , 12 , 13 , 14 , 15 , 16 ]. Thus, physical activity not only reduces the development of rectal cancer [ 4 , 7 ], but is also associated with prolonged survival after diagnosis [ 4 , 6 ].…”

“…Numerous studies and meta-analyses have shown a positive correlation between physical activity and overall survival [ 4 , 5 , 6 , 7 , 8 , 11 , 12 , 13 , 14 , 15 , 16 ]. Thus, physical activity not only reduces the development of rectal cancer [ 4 , 7 ], but is also associated with prolonged survival after diagnosis [ 4 , 6 ]. Recurrent difficulties for the meta-analyses were the comparability of the level of physical activity and subsequent categorization into low, moderate, and high physical activity of the studies assessed [ 9 ].…”

“…For several years, the protective effect of physical activity on the development of RC [ 4 , 5 ] and the positive influence on the outcome [ 4 , 6 ] have been known. The latest meta-analysis from January 2021 on this topic reconfirmed the association between physical activity and RC, and further showed positive influences of physical activity on 12 other tumor entities [ 7 ].…”

Supportive Care in Oncology—From Physical Activity to Nutrition

“…Whereas, in the past, the goal of sports and exercise therapy in tertiary prevention or rehabilitation was initially only seen as improving quality of life and fatigue, epidemiological observational studies also show a decrease in the recurrence rate with greater physical activity compared to inactive people [ 22 ]. The American Cancer Society Nutrition and Physical Activity Guidelines for Cancer Survivors recommended a healthy lifestyle including healthy body weight, physical activity, and a diet that includes vegetables, fruits, and whole grains.…”

Physical Activity Is Associated with Improved Overall Survival among Patients with Metastatic Colorectal Cancer

“…A physically active lifestyle is broadly considered to be related to a decreased risk of developing colorectal cancer (CRC), with evidence being especially strong for colon cancer [ 1 , 2 , 3 , 4 , 5 ]. After a cancer diagnosis, several studies show beneficial associations between high levels of physical activity (PA) and reduced mortality in stage I–III CRC patients as well [ 6 , 7 , 8 , 9 , 10 , 11 ].…”