Association of Physical Activity Intensity with All-Cause Mortality in Cancer Survivors: A National Prospective Cohort Study
1
Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
2
Department of Oncology, Xiangya Hospital, Central South University, Changsha 410017, China
3
Research Center of Carcinogenesis and Targeted Therapy, Xiangya Hospital, Central South University, Changsha 410017, China
4
National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Changsha 410017, China
*
Author to whom correspondence should be addressed.
Cancers 2022, 14(23), 5760; https://doi.org/10.3390/cancers14235760
Submission received: 8 October 2022
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Revised: 10 November 2022
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Accepted: 21 November 2022
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Published: 23 November 2022
(This article belongs to the Special Issue Lifestyle Modifications and Survival of Cancer Patients)
Simple Summary
Insufficient physical activity (PA) is a global health issue with significant disease burden. Increasing evidence suggests that higher PA levels have protective effects against chronic diseases. Few prospective cohort studies have explored the association between PA levels and mortality in cancer survivors. Using a large nationally representative survey population of United States adults, this study demonstrated a beneficial association between leisure-time PA and all-cause mortality in cancer survivors. There was a nonlinear relationship between the total PA and the risk of all-cause mortality. Threshold effect analysis demonstrated that cancer survivors should perform PA for at least 1 h per week and performing more PA could provide additional survival benefits for cancer survivors.
Abstract
We designed this study to investigate the associations between physical activity (PA) and the risk of all-cause mortality in cancer survivors using a nationally representative cohort of US adults. This cohort study included 13 cycles of the National Health Interview Surveys, and by matching participants with the National Death Index (2015), survival status was determined. The main outcome was all-cause mortality during follow-up. A total of 20,088 participants aged 62.2 (15.9) years (62.4% women) were analyzed. After an average follow-up of 117.5 months, 7214 (35.9%) participants died. Compared with inactive cancer survivors, we observed a 25% lower all-cause mortality risk among participants performing PA 10 min to 1 h/week (hazard ratio [HR] = 0.75, 95% confidence interval [CI] = 0.67–0.85), a 28% lower risk among those performing PA 1–2.5 h/week (HR = 0.72, 95% CI = 0.67–0.78), a 34% lower risk among those performing PA 2.5–5 h/week (HR = 0.66, 95% CI = 0.60–0.72), a 37% lower risk among those performing PA 5–7.5 h/week (HR = 0.63, 95% CI = 0.56–0.70), a 47% lower risk among those performing PA 7.5–13.3 h/week (HR = 0.53, 95% CI = 0.47–0.61), and a 43% lower risk among those performing PA 13.3–24 h/week (adjusted HR = 0.53, 95% CI = 0.49–0.66). In cancer survivors, leisure-time PA was associated with a lower all-cause mortality. Inactive cancer survivors should be encouraged to perform more PA to reduce the risk of all-cause mortality.
Keywords:
physical activity; all-cause mortality; NHIS; cancer survivors
