Pan-cancer analysis of postdiagnosis exercise and mortality Journal Article
| Authors: | Lavery, J. A.; Boutros, P. C.; Scott, J. M.; Tammela, T.; Moskowitz, C. S.; Jones, L. W. |
| Article Title: | Pan-cancer analysis of postdiagnosis exercise and mortality |
| Abstract: | PURPOSE: The impact of postdiagnosis exercise on cause-specific mortality in cancer survivors and whether this differs on the basis of cancer site is unclear. METHODS: We performed an analysis of 11,480 patients with cancer enrolled in the Prostate, Lung, Colorectal, and Ovarian cancer screening trial. Patients with a confirmed diagnosis of cancer completing a standardized survey quantifying exercise after diagnosis were included. The primary outcome was all-cause mortality (ACM); secondary end points were cancer mortality and mortality from other causes. Cox models were used to estimate the cause-specific hazard ratios (HRs) for ACM, cancer, and noncancer mortality as a function of meeting exercise guidelines versus not meeting guidelines with adjustment for important clinical covariates. RESULTS: After a median follow-up of 16 years from diagnosis, 4,665 deaths were documented (1,940 due to cancer and 2,725 due to other causes). In multivariable analyses, exercise consistent with guidelines was associated with a 25% reduced risk of ACM compared with nonexercise (HR, 0.75; 95% CI, 0.70 to 0.80). Compared with nonexercise, exercise consistent with guidelines was associated with a significant reduction in cancer mortality (HR, 0.79; 95% CI, 0.72 to 0.88) and mortality from other causes (HR, 0.72; 95% CI, 0.66 to 0.78). The inverse relationship between exercise and cause-specific mortality varied by exercise dose. Exercise consistent with guidelines was associated with a reduced hazard of ACM for multiple cancer sites. Reduction in cancer mortality for exercisers was only observed in head and neck and renal cancer. CONCLUSION: In this pan-cancer sample of long-term cancer survivors, exercise consistent with guidelines was associated with substantial ACM benefit driven by both reductions in cancer and noncancer mortality. The cause-specific impact of exercise differed as a function of cancer site. |
| Keywords: | ovarian neoplasms; proportional hazards models; exercise; cancer survivor; proportional hazards model; ovary tumor; cancer survivors; humans; human; male; female |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 41 |
| Issue: | 32 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2023-11-10 |
| Start Page: | 4982 |
| End Page: | 4992 |
| Language: | English |
| DOI: | 10.1200/jco.23.00058 |
| PUBMED: | 37651670 |
| PROVIDER: | scopus |
| PMCID: | PMC11659968 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Lee Jones -- Source: Scopus |
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