Change patterns and determinants of physical activity differ between breast, prostate, and colorectal cancer patients
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The purpose of this study was to examine and compare pre- to post-diagnosis change patterns of physical activity (PA) among breast, prostate, and colorectal cancer patients. Moreover, the study aimed to investigate sociodemographic and medical determinants of post-diagnosis PA and to identify patient subgroups at increased risk of inactivity.
A total of 912 cancer patients (457 breast, 241 prostate, 214 colorectal cancer) completed a questionnaire assessing their pre- and post-diagnosis PA behavior, and sociodemographic and medical variables. Age-adjusted regression and classification tree analyses were used to investigate PA determinants and detect subgroups that were most likely to meet or not meet PA guidelines.
Across cancer types, we found that PA yet decreased from pre- to post-diagnosis, but that 54.1% of participants still reported to be meeting PA guidelines after the diagnosis. While post-diagnosis PA was strongly affected by previous PA behavior among individuals of all patient groups, other sociodemographic and medical determinants played different roles depending on cancer type. The results yielded that previously active, longer diagnosed patients with higher education levels were most likely to be meeting PA guidelines post-diagnosis, whereas specifically previously inactive prostate cancer patients had an increased likelihood of insufficient activity.
An encouragingly high number of cancer patients indicated sufficient PA levels. For those having difficulties to maintain or adopt PA post-diagnosis, interventions should be tailored to the specific characteristics of each cancer type, as different factors are associated with PA for each patient group.
KeywordsPhysical activity Breast cancer Prostate cancer Colorectal cancer Determinants Change patterns
We thank Fiona Rupprecht, Lena Radke, Nina Immel, Sara Kuru, Sophie Madlinger, Elisa Ebler, and Xenia Peukert for their help in the recruitment, coding procedure, and data management.
This study was part of the Momentum Project that has been supported by a grant from the German Cancer Aid (Grant No. 110512, 110551, and 111223).
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. The authors declare that they have full control of all primary data and that they agree to allow the journal to review our data.
- 1.Demark-Wahnefried W, Rogers LQ, Alfano CM, Thomson CA, Courneya KS, Meyerhardt JA, Stout NL, Kvale E, Ganzer H, Ligibel JA (2015) Practical clinical interventions for diet, physical activity, and weight control in cancer survivors. CA Cancer J Clin 65(3):167–189. https://doi.org/10.3322/caac.21265 CrossRefPubMedGoogle Scholar
- 2.Buffart LM, Kalter J, Sweegers MG, Courneya KS, Newton RU, Aaronson NK, Jacobsen PB, May AM, Galvao DA, Chinapaw MJ, Steindorf K, Irwin ML, Stuiver MM, Hayes S, Griffith KA, Lucia A, Mesters I, van Weert E, Knoop H, Goedendorp MM, Mutrie N, Daley AJ, McConnachie A, Bohus M, Thorsen L, Schulz KH, Short CE, James EL, Plotnikoff RC, Arbane G, Schmidt ME, Potthoff K, van Beurden M, Oldenburg HS, Sonke GS, van Harten WH, Garrod R, Schmitz KH, Winters-Stone KM, Velthuis MJ, Taaffe DR, van Mechelen W, Kersten MJ, Nollet F, Wenzel J, Wiskemann J, Verdonck-de Leeuw IM, Brug J (2017) Effects and moderators of exercise on quality of life and physical function in patients with cancer: an individual patient data meta-analysis of 34 RCTs. Cancer Treat Rev 52:91–104. https://doi.org/10.1016/j.ctrv.2016.11.010 CrossRefPubMedGoogle Scholar
- 7.Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvão DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42(7):1409–1426. https://doi.org/10.1249/mss.0b013e3181e0c112 CrossRefPubMedGoogle Scholar
- 9.Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Niksic M, Bonaventure A, Valkov M, Johnson CJ, Esteve J, Ogunbiyi OJ, Azevedo ESG, Chen WQ, Eser S, Engholm G, Stiller CA, Monnereau A, Woods RR, Visser O, Lim GH, Aitken J, Weir HK, Coleman MP (2018) Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet 391(10125):1023–1075. https://doi.org/10.1016/s0140-6736(17)33326-3 CrossRefPubMedPubMedCentralGoogle Scholar
- 11.Fassier P, Zelek L, Partula V, Srour B, Bachmann P, Touillaud M, Druesne-Pecollo N, Galan P, Cohen P, Hoarau H, Latino-Martel P, Menai M, Oppert JM, Hercberg S, Deschasaux M, Touvier M (2016) Variations of physical activity and sedentary behavior between before and after cancer diagnosis: Results from the prospective population-based NutriNet-Sante cohort. Medicine 95(40):e4629. https://doi.org/10.1097/MD.0000s000000004629 CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Eng L, Pringle D, Su J, Shen X, Mahler M, Niu C, Charow R, Tiessen K, Lam C, Halytskyy O, Naik H, Hon H, Irwin M, Pat V, Gonos C, Chan C, Villeneuve J, Harland L, Shani RM, Brown MC, Selby P, Howell D, Xu W, Liu G, Alibhai SMH, Jones JM (2018) Patterns, perceptions, and perceived barriers to physical activity in adult cancer survivors. Support Care Cancer 26(11):3755–3763. https://doi.org/10.1007/s00520-018-4239-5 CrossRefPubMedGoogle Scholar
- 13.Boyle T, Vallance JK, Ransom EK, Lynch BM (2016) How sedentary and physically active are breast cancer survivors, and which population subgroups have higher or lower levels of these behaviors? Support Care Cancer 24(5):2181–2190. https://doi.org/10.1007/s00520-015-3011-3 CrossRefPubMedGoogle Scholar
- 14.Galvao DA, Newton RU, Gardiner RA, Girgis A, Lepore SJ, Stiller A, Occhipinti S, Chambers SK (2015) Compliance to exercise-oncology guidelines in prostate cancer survivors and associations with psychological distress, unmet supportive care needs, and quality of life. Psycho-oncology 24(10):1241–1249. https://doi.org/10.1002/pon.3882 CrossRefPubMedGoogle Scholar
- 17.Buffart LM, Thong MS, Schep G, Chinapaw MJ, Brug J, van de Poll-Franse LV (2012) Self-reported physical activity: its correlates and relationship with health-related quality of life in a large cohort of colorectal cancer survivors. PLoS One 7(5):e36164. https://doi.org/10.1371/journal.pone.0036164 CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Speed-Andrews AE, Rhodes RE, Blanchard CM, Culos-Reed SN, Friedenreich CM, Belanger LJ, Courneya KS (2012) Medical, demographic and social cognitive correlates of physical activity in a population-based sample of colorectal cancer survivors. Eur J Cancer Care (Engl) 21(2):187–196. https://doi.org/10.1111/j.1365-2354.2011.01290.x CrossRefGoogle Scholar
- 20.van Putten M, Husson O, Mols F, Luyer MDP, van de Poll-Franse LV, Ezendam NPM (2016) Correlates of physical activity among colorectal cancer survivors: results from the longitudinal population-based profiles registry. Support Care Cancer 24(2):573–583. https://doi.org/10.1007/s00520-015-2816-4 CrossRefPubMedGoogle Scholar
- 21.Kampshoff CS, Stacey F, Short CE, van Mechelen W, Chinapaw MJ, Brug J, Plotnikoff R, James EL, Buffart LM (2016) Demographic, clinical, psychosocial, and environmental correlates of objectively assessed physical activity among breast cancer survivors. Support Care Cancer 24(8):3333–3342. https://doi.org/10.1007/s00520-016-3148-8 CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Schmidt ME, Wiskemann J, Ulrich CM, Schneeweiss A, Steindorf K (2017) Self-reported physical activity behavior of breast cancer survivors during and after adjuvant therapy: 12 months follow-up of two randomized exercise intervention trials. Acta Oncol 56(4):618–627. https://doi.org/10.1080/0284186X.2016.1275776 CrossRefPubMedGoogle Scholar
- 25.Hawkes AL, Patrao TA, Baade P, Lynch BM, Courneya KS (2015) Predictors of physical activity in colorectal cancer survivors after participation in a telephone-delivered multiple health behavior change intervention. J Cancer Surviv 9(1):40–49. https://doi.org/10.1007/s11764-014-0389-8 CrossRefPubMedGoogle Scholar
- 26.Hackshaw-McGeagh LE, Penfold CM, Walsh E, Donovan JL, Hamdy FC, Neal DE, Jeffreys M, Martin RM, Lane JA, Protec TSG (2015) Physical activity, alcohol consumption, BMI and smoking status before and after prostate cancer diagnosis in the ProtecT trial: opportunities for lifestyle modification. Int J Cancer 137(6):1509–1515. https://doi.org/10.1002/ijc.29514 CrossRefPubMedPubMedCentralGoogle Scholar
- 27.LeMasters TJ, Madhavan SS, Sambamoorthi U, Kurian S (2014) Health behaviors among breast, prostate, and colorectal cancer survivors: a US population-based case-control study, with comparisons by cancer type and gender. J Cancer Surviv 8(3):336–348. https://doi.org/10.1007/s11764-014-0347-5 CrossRefPubMedPubMedCentralGoogle Scholar
- 33.Haussmann A, Ungar N, Gabrian M, Tsiouris A, Sieverding M, Wiskemann J, Steindorf K (2018) Are healthcare professionals being left in the lurch? The role of structural barriers and information resources to promote physical activity to cancer patients. Support Care Cancer 26(12):4087–4096. https://doi.org/10.1007/s00520-018-4279-x CrossRefPubMedGoogle Scholar
- 37.Davis CE (1976) The effect of regression to the mean in epidemiologic and clinical studies. Am J Epidemiol 104(5):493–498. https://doi.org/10.1093/oxfordjournals.aje.a112321 CrossRefPubMedGoogle Scholar
- 38.Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, Keadle SK, Arem H, Berrington de Gonzalez A, Hartge P, Adami HO, Blair CK, Borch KB, Boyd E, Check DP, Fournier A, Freedman ND, Gunter M, Johannson M, Khaw KT, Linet MS, Orsini N, Park Y, Riboli E, Robien K, Schairer C, Sesso H, Spriggs M, Van Dusen R, Wolk A, Matthews CE, Patel AV (2016) Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Intern Med 176(6):816–825. https://doi.org/10.1001/jamainternmed.2016.1548 CrossRefPubMedPubMedCentralGoogle Scholar
- 39.Schuch F, Vancampfort D, Firth J, Rosenbaum S, Ward P, Reichert T, Bagatini NC, Bgeginski R, Stubbs B (2017) Physical activity and sedentary behavior in people with major depressive disorder: a systematic review and meta-analysis. J Affect Disord 210:139–150. https://doi.org/10.1016/j.jad.2016.10.050 CrossRefPubMedGoogle Scholar
- 42.Cornford P, Bellmunt J, Bolla M, Briers E, De Santis M, Gross T, Henry AM, Joniau S, Lam TB, Mason MD, van der Poel HG, van der Kwast TH, Rouviere O, Wiegel T, Mottet N (2017) EAU-ESTRO-SIOG guidelines on prostate cancer. Part II: treatment of relapsing, metastatic, and castration-resistant prostate cancer. Eur Urol 71(4):630–642. https://doi.org/10.1016/j.eururo.2016.08.002 CrossRefPubMedGoogle Scholar
- 46.Ungar N, Schmidt L, Gabrian M, Haussmann A, Tsiouris A, Sieverding M, Steindorf K, Wiskemann J (2019) Which self-management strategies do health care professionals recommend to their cancer patients? An experimental investigation of patient age and treatment phase. J Behav Med 42(2):342–352. https://doi.org/10.1007/s10865-018-9980-1 CrossRefPubMedGoogle Scholar
- 48.Amireault S, Godin G, Lacombe J, Sabiston CM (2015) Validation of the Godin-Shephard Leisure-Time Physical Activity Questionnaire classification coding system using accelerometer assessment among breast cancer survivors. J Cancer Surviv 9(3):532–540. https://doi.org/10.1007/s11764-015-0430-6 CrossRefPubMedGoogle Scholar