Systematic Review: Recommendations of Levels of Physical Activity among Colorectal Cancer Patients (2010–2019)

Abstract

Background: It is necessary to engage in an appropriate level of physical activity to improve the prognoses of colorectal cancer patients, yet no guidelines currently exist. The goals of this systematic review are to determine the impact of levels of physical activity on the prognoses of colorectal cancer patients and to suggest recommended guidelines for levels of physical activity. Methods: This systematic review was conducted along PRISMA guidelines. Per the inclusion criteria, papers published in academic journals in English from 2010 to 2019 were selected. A literature search was performed on PubMed (Medline), and the results of the selected studies were qualitatively synthesized. Results: Of the 13 cohort studies included in this systematic review, most studies were conducted in the United States (N = 7). Immobility or low levels of physical activity adversely affected the prognoses of colorectal cancer patients. Contrarily, high levels of physical activity increased the survival rate in people with colorectal cancer. Conclusion: For colorectal cancer patients, a level of physical activity of 17.5 to 35 MET hours per week is strongly recommended, which has been shown to reduce mortality by approximately 30 to 40%. Patients with limited physical capacity should maintain a minimum level of physical activity (≥ 3.5 MET hours/week).

Impact of pre‐ and post‐diagnosis physical activity on the mortality of patients with cancer: Results from the Health Examinees‐G study in Korea

“…In addition, unlike previous studies, we suggest an optimal modality of PA in which intensity is the most significant characteristic pre‐diagnosis for the secondary prevention of colorectal cancer. In addition, considering that mountain climbing, which also has a long duration, is the main source of vigorous‐intensity LTPA, a longer duration of vigorous‐intensity PA would be the most significant characteristic of LTPA in Asian cancer patients, like in Caucasian colorectal cancer patients 25 . There is abundant evidence for the protective effect of PA on the mortality of colorectal cancer survivors in different periods 26 .…”

“…In addition, considering that mountain climbing, which also has a long duration, is the main source of vigorous‐intensity LTPA, a longer duration of vigorous‐intensity PA would be the most significant characteristic of LTPA in Asian cancer patients, like in Caucasian colorectal cancer patients. 25 There is abundant evidence for the protective effect of PA on the mortality of colorectal cancer survivors in different periods. 26 For example, pre‐ and post‐diagnosis PA are reported to be associated with a lower risk of all‐cause mortality.…”

Density of CD3+ and CD8+ Cells in the Microenvironment of Colorectal Cancer according to Prediagnostic Physical Activity

“…Physical activity may, therefore, have a threshold rather than a dose-response relationship with tumor immune cell infiltration, occurring at higher physical activity levels. The amount of physical activity required to lower the risk and mortality of colorectal cancer is not known, and the evidence to date does not permit distinction between a threshold or dose-response effect (1,5,(40)(41)(42).…”

Colorectal Cancer: A Review of Carcinogenesis, Global Epidemiology, Current Challenges, Risk Factors, Preventive and Treatment Strategies

“…A level of physical activity of 17.5 to 35 metabolic equivalent task (MET) hours per week is strongly recommended for CRC patients, which has cut mortality by 30 to 40%. Patients with limited physical capabilities should engage in at least 3.5 MET-hours per week of physical activity [ 91 ]. A study involving 573 women with stage I and III CRC revealed that increasing levels of exercise after a diagnosis of non-metastatic CRC reduced cancer-specific mortality with p for trend was 0.008, and overall mortality with p for trend was 0.003 [ 92 ].…”