Physical activity before and after cancer diagnosis and mortality risk in three large prospective cohorts
Menée à partir des données de 3 cohortes prospectives incluant 10 541 patients atteints d'un cancer, cette étude analyse l'effet, sur la mortalité, de la pratique d'une activité physique avant et après le diagnostic de la maladie
Purpose: Physical activity (PA) can improve cancer survival; however, whether the timing of PA differentially affects mortality risk is unclear. We evaluated the association between PA levels pre- and post-diagnosis and mortality risk in the Women’s Health Study (WHS), Physicians’ Health Study (PHS)-I, and PHS-II prospective cohorts.
Methods: We categorized PA pre- and post-diagnosis as active (WHS:
≥
7.5 metabolic equivalent (MET)-h/week; PHS: vigorous PA
≥
2–4 times/week) or inactive. We analyzed changes in pre- and post-diagnosis PA levels as four joint categories: (1) Inactive
→
Inactive, (2) Active
→
Inactive, (3) Inactive
→
Active, and (4) Active
→
Active, on mortality risk using multivariable Cox proportional hazards regression.
Results: We identified 10,541 participants with incident cancer and 3,696 deaths during follow-up. Compared to maintaining inactivity in both periods, remaining active pre- and post-diagnosis observed lower all-cause (Hazard Ratio [95% confidence interval]: WHS: 0.55 [0.47–0.64]; PHS-I: 0.77 [0.67–0.88]), cancer (WHS: 0.55 [0.45–0.67]; PHS-I: 0.75; [0.61–0.92]) and non-cancer/cardiovascular disease (CVD) mortality risks (WHS: 0.49 [0.38–0.65]). Similarly, becoming active post-diagnosis was associated with lower all-cause (WHS: 0.60 (0.48–0.75]; PHS-I: 0.72 [0.61–0.88]), cancer (WHS: 0.65 [0.49–0.86]; PHS-I: 0.64 [0.49–0.84]), and non-cancer/CVD mortality risk (WHS: 0.49 [0.33–0.75]). Being active pre- and post-diagnosis was associated with lower mortality risks in separate analyses, although significance differed by cohort and outcome.
Conclusions: Remaining active pre- and post-diagnosis and becoming active post-diagnosis may be associated with improvements in cancer survival, however, research is needed across diverse cancer populations.
Cancer Causes & Control , résumé, 2024