Live Virtual Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

The relationship between physical activity and survival following cancer  (#68)

Sandi Hayes 1
  1. Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia

Since the mid-2000’s, there has been an exponential rise in studies evaluating the link between physical activity (PA) and survival outcomes following cancer.  In part, as a consequence of the growth in this research, the momentum behind endorsing and promoting PA in the management of cancer has also grown. Concurrently though, concerns have been raised about whether there is sufficient evidence to support the benefits of PA participation for all people with cancer, or alternatively whether the evidence only supports benefit through PA for specific cancer types or subgroups within cancer types (that is, is dependent on sex, body mass index, menopausal status, or subtypes within a specific cancer). Hence, a rigorous review of the rapidly evolving evidence base was undertaken to evaluate the association between pre- and post-diagnosis PA and survival (primary outcomes: cancer-specific mortality, all-cause mortality and cardiovascular disease mortality) for all-cancer and by specific cancer sites, by using data from all available observational epidemiologic studies and randomised controlled trials. Secondary objectives of the review included assessing these associations by sex, body mass index, menopausal status and colorectal cancer subtype, and to determine the dose-response relationship between PA and cancer survival. The methods and findings from this review will be outlined during this presentation. In summary, evidence supports improved survival outcomes in those with the highest versus lowest levels of pre- or post-diagnosis total/recreational PA for all-cancers combined (cancer-specific mortality: HR=0.82, 95% CI=0.79-0.86; and HR=0.63, 95% CI=0.53-0.75, respectively), as well as for 11 specific cancer sites. Survival benefits through PA were observed in most subgroups examined. Further, inverse dose-response relationships between PA and breast cancer-specific and all-cause mortality were observed, with steep reductions in hazards to 10-15 metabolic equivalent hours per week. The implications of these findings on PA recommendations will be also be discussed.