Journal of Cancer Survivorship

, Volume 12, Issue 5, pp 679–690 | Cite as

Potential determinants of physical inactivity among long-term colorectal cancer survivors

  • Ruth Elisa Eyl
  • Lena Koch-Gallenkamp
  • Lina Jansen
  • Viola Walter
  • Prudence Carr
  • Michael Hoffmeister
  • Jenny Chang-Claude
  • Hermann Brenner
  • Volker Arndt



Since physical activity (PA) has been shown to be associated with better prognosis and quality of life (QOL) in colorectal cancer (CRC) patients, this study focuses on the barriers of PA among CRC survivors.


This study is based on a population-based study from Germany of 1343 women and men, diagnosed with CRC between 2003 and 2008 and being alive five years later. Multivariable logistic regression was used to explore associations between baseline as well as five-year follow-up (5YFU) characteristics and physical inactivity (PIA) at 5YFU. Quartiles were calculated based on metabolic equivalent hours per week of PA at baseline and at 5YFU. Participants in quartile 1 were defined as physically inactive, and patients in quartile 2 to quartile 4 were defined as physically active.


Cancer-specific factors such as having a stoma (odds ratio (OR) = 1.51, 95% confidence interval (CI) = 1.12–2.04), demographic factors such as living in a small town or city (OR = 1.46, 95% CI = 1.05–2.02; OR = 1.42, 95% CI = 1.01–2.02), older age (OR = 1.44, 95% CI = 0.80–2.58), or being divorced (OR = 1.72, 95% CI = 0.96–3.07), as well as lifestyle factors such as being a current smoker (OR = 1.54, 95% CI = 1.04–2.29) or being obese (OR = 1.43, 95% CI = 0.96–2.13) were associated with PIA at 5YFU. Subgroup analyses showed that the association between body mass index  and PIA was stronger in women than in men. Baseline PA was identified as a strong predictor of PIA at 5YFU.


Findings suggest that predominately patients with a stoma, patients living in a more populated area, being older, divorced, a current smoker, or obese were more likely to be physically inactive and therefore could be targeted to be more physically active.

Implications for Cancer Survivors

Addressing barriers for PA might help to develop specific, individually tailored PA interventions to overcome PIA and improve the long-term outcome of CRC survivors.


Colorectal cancer Cancer survivors Physical inactivity Exercise Barriers Long-term survivorship 



The authors thank Ute Handte-Daub, Ansgar Brandhorst, and Petra Bächer for their excellent technical assistance. The authors thank the study participants and the interviewers who collected the data. The authors also thank the following hospitals and cooperating institutions that recruited patients for this study: Chirurgische Universitätsklinik Heidelberg, Klinik am Gesundbrunnen Heilbronn, St. Vincentiuskrankenhaus Speyer, St. Josefskrankenhaus Heidelberg, Chirurgische Universitätsklinik Mannheim, Diakonissenkrankenhaus Speyer, Krankenhaus Salem Heidelberg, Kreiskrankenhaus Schwetzingen, St. Marienkrankenhaus Ludwigshafen, Klinikum Ludwigshafen, Stadtklinik Frankenthal, Diakoniekrankenhaus Mannheim, Kreiskrankenhaus Sinsheim, Klinikum am Plattenwald Bad Friedrichshall, Kreiskrankenhaus Weinheim, Kreiskrankenhaus Eberbach, Kreiskrankenhaus Buchen, Kreiskrankenhaus Mosbach, Enddarmzentrum Mannheim, Kreiskrankenhaus Brackenheim, and Cancer Registry of Rhineland-Palatinate, Mainz.


This work was supported by the German Research Council (BR 1704/6-1, BR 1704/6-3, BR 1704/6-4, CH 117/1-1) and the German Federal Ministry of Education and Research (01KH0404, 01ER0814, 01ER0815, 01ER1505A, and 01ER1505B).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11764_2018_705_MOESM1_ESM.docx (38 kb)
Supplementary Table 1 (DOCX 37 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Ruth Elisa Eyl
    • 1
    • 2
  • Lena Koch-Gallenkamp
    • 1
  • Lina Jansen
    • 1
  • Viola Walter
    • 1
  • Prudence Carr
    • 1
  • Michael Hoffmeister
    • 1
  • Jenny Chang-Claude
    • 3
  • Hermann Brenner
    • 1
    • 4
    • 5
  • Volker Arndt
    • 6
  1. 1.Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research Center (DKFZ)HeidelbergGermany
  2. 2.Medical Faculty HeidelbergUniversity of HeidelbergHeidelbergGermany
  3. 3.Unit of Genetic Epidemiology, Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
  4. 4.Division of Preventive OncologyGerman Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT)HeidelbergGermany
  5. 5.German Cancer Consortium (DKTK)German Cancer Research Center (DKFZ)HeidelbergGermany
  6. 6.Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research Center (DKFZ)HeidelbergGermany

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