Leisure-time physical activity after diagnosis and survival by cancer type: a pooled analysis

BACKGROUND: Evidence for potential mortality benefits of leisure-time moderate-to-vigorous intensity physical activity (MVPA) for survivors of cancer types beyond breast and colorectal is limited. The aim of this study was to evaluate relationships between postdiagnosis MVPA and all-cause mortality in participants with a history of 11 cancer types. METHODS: Data were pooled from 6 United States-based cohort studies. Cohort-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for associations of MVPA assessed ≥1 year after a cancer diagnosis and all-cause mortality were calculated using multivariable Cox proportional hazards models and then pooled using random effects meta-analysis. Models were adjusted for age, sex, race/ethnicity, smoking status, alcohol use, and cancer treatment and stage. The sample included 90 844 cancer survivors (mean standard deviation age at diagnosis = 67 10 years, 55% women), among whom 45 477 died during 10.9 7.0 years of follow-up. RESULTS: Compared with no MVPA, engaging in recommended amounts of MVPA (7.5 to <15 MET-hr/wk) was related to better overall survival in participants with a history of 1 of 10 cancer types: oral (HR = 0.44, 95% CI = 0.27 to 0.73), endometrial (0.50, 95% CI = 0.34 to 0.76), lung (0.51, 95% CI = 0.38 to 0.68), rectal (0.51, 95% CI = 0.36 to 0.71), respiratory (0.51, 95% CI = 0.29 to 0.72), bladder (0.53, 95% CI = 0.40 to 0.72), kidney (0.53, 95% CI = 0.37 to 0.77), prostate (0.60,95% CI = 0.49 to 0.74), colon (0.61, 95% CI = 0.50 to 0.76), and breast (0.67, 95% CI = 0.55 to 0.81). Eight of the 10 observed inverse associations remained similar when excluding participants who died within 2 years of follow-up. CONCLUSION: Engaging in leisure-time MVPA after a cancer diagnosis appears to improve survival for people with a history of several cancer types, including bladder, breast, colon, endometrial, kidney, lung, oral, prostate, rectal, and respiratory cancer.