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Recreational physical activity, body mass index, and survival in women with colorectal cancer |
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| Authors: | Josephina G. Kuiper Amanda I. Phipps Marian L. Neuhouser Rowan T. Chlebowski Cynthia A. Thomson Melinda L. Irwin Dorothy S. Lane Jean Wactawski-Wende Lifang Hou Rebecca D. Jackson Ellen Kampman Polly A. Newcomb |
| Affiliation: | 1. Division of Human Nutrition, Wageningen University, Bomenweg 4, 6703 HD, Wageningen, The Netherlands 2. Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M4-B402, P.O. Box 19024, Seattle, WA, 98109, USA 3. Los Angeles Biomedical Research Institute Harbor-UCLA Medical Center, 1124 West Carson St, Torrance, CA, 90502, USA 4. Department of Nutritional Sciences, University of Arizona, PO Box 210458, 1145 S Warren, Tucson, AZ, 85721, USA 5. Yale School of Public Health, Yale University, 60 College Street, P.O. Box 208034, New Haven, CT, 06520-8034, USA 6. Community and Behavioral Health Faculty, Stony Brook University Medical Center, 101 Nicolls Road, Stony Brook, NY, 11794, USA 7. Department of Social and Preventive Medicine, University at Buffalo, 270 Farber Hall, Buffalo, NY, 14214, USA 8. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680?N. Lake Shore Drive, Suite 1400, Chicago, IL, 6061, USA 9. Division of Endocrinology, Diabetes and Metabolism, Ohio State University, 491 McCampbell Hall 1581 Dodd Drive, Columbus, OH, 43210, USA 10. Department of Health Sciences, VU Amsterdam, De Boelelaan 1105, 1081 HV, Amsterdam, The Netherlands |
| Abstract: | Background and purposePrevious studies have shown that physical inactivity and obesity are risk factors for the development of colorectal cancer. However, controversy exists regarding the influence of these factors on survival in colorectal cancer patients. We evaluated the impact of recreational physical activity and body mass index (BMI) before and after colorectal cancer diagnosis on disease-specific mortality and all-cause mortality.Patients and methodsThis prospective cohort study included 1,339 women enrolled in the Women’s Health Initiative study who were diagnosed with colorectal cancer subsequent to study enrollment. BMI and recreational physical activity were measured before cancer diagnosis at study entry (pre-diagnostic) and after diagnosis at study follow-up interviews (post-diagnostic). We used Cox regression to estimate the association between pre- and post-diagnostic exposures and survival after colorectal cancer diagnosis.ResultsAmong women diagnosed with colorectal cancer, 265 (13?%) deaths occurred during a median study follow-up of 11.9?years, of which 171 (65?%) were attributed to colorectal cancer. Compared with women reporting no pre-diagnostic recreational physical activity, those reporting activity levels of ≥18 MET-h/week had significantly lower colorectal cancer-specific mortality (hazard ratio (HR)?=?0.68; 95?% confidence interval (CI): 0.41–1.13) and all-cause mortality (HR?=?0.63; 95?% CI: 0.42–0.96). Similar inverse associations were seen for post-diagnostic recreational physical activity. Neither pre- nor post-diagnostic BMI were associated with mortality after colorectal cancer diagnosis.ConclusionRecreational physical activity before and after colorectal cancer diagnosis, but not BMI, is associated with more favorable survival. |
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