Post-diagnosis physical activity and sedentary behaviour and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Georgios Markozannes
  • Nerea Becerra-Tomás
  • Margarita Cariolou
  • Katia Balducci
  • Rita Vieira
  • Sonia Kiss
  • Dagfinn Aune
  • Darren C. Greenwood
  • Marc J. Gunter
  • Ellen Copson
  • Andrew G. Renehan
  • Martijn Bours
  • Wendy Demark-Wahnefried
  • Melissa M. Hudson
  • Anne M. May
  • Folakemi T. Odedina
  • Roderick Skinner
  • Karen Steindorf
  • Galina Velikova
  • Monica L. Baskin
  • Rajiv Chowdhury
  • Lynette Hill
  • Sarah J. Lewis
  • Jaap Seidell
  • Matty P. Weijenberg
  • John Krebs
  • Amanda J. Cross
  • Konstantinos K. Tsilidis
  • Doris S.M. Chan
Low physical activity and high sedentary behaviour have been clearly linked with colorectal cancer development, yet data on their potential role in colorectal cancer survival is limited. Better characterisation of these relationships is needed for the development of post-diagnosis physical activity and sedentary behaviour guidance for colorectal cancer survivors. We searched PubMed and Embase through 28 February 2022 for studies assessing post-diagnosis physical activity, and/or sedentary behaviour in relation to all-cause and cause-specific mortality and recurrence after colorectal cancer diagnosis. Total and recreational physical activity were assessed overall and by frequency, duration, intensity, and volume using categorical, linear, and non-linear dose–response random-effects meta-analyses. The Global Cancer Update Programme (CUP Global) independent Expert Committee on Cancer Survivorship and Expert Panel interpreted and graded the likelihood of causality. We identified 16 observational studies on 82,220 non-overlapping patients from six countries. Physical activity was consistently inversely associated with colorectal cancer morbidity and mortality outcomes, with 13%–60% estimated reductions in risk. Sedentary behaviour was positively associated with all-cause mortality. The evidence had methodological limitations including potential confounding, selection bias and reverse causation, coupled with a limited number of studies for most associations. The CUP Global Expert panel concluded limited-suggestive evidence for recreational physical activity with all-cause mortality and cancer recurrence. Total physical activity and its specific domains and dimensions, and sedentary behaviour were all graded as limited-no conclusion for all outcomes. Future research should focus on randomised trials, while observational studies should obtain objective and repeated physical activity measures and better adjustment for confounders.
OriginalsprogEngelsk
TidsskriftInternational Journal of Cancer
ISSN0020-7136
DOI
StatusAccepteret/In press - 2024

Bibliografisk note

Funding Information:
This work was funded by the World Cancer Research Fund network of charities (American Institute for Cancer Research [AICR]; World Cancer Research Fund [WCRF]; Wereld Kanker Onderzoek Fonds [WKOF]) (CUP Global Special Grant 2018). The funders of this study had no role in the decisions about the design and conduct of the study; collection, management, analysis, or interpretation of the data; or the preparation, review, or approval of the manuscript. The process used was based on the method developed by WCRF International's Methodology Task Force for the WCRF/AICR Second Expert Report. The views expressed in this review are the opinions of the authors. They may differ from those in future updates of the evidence related to food, nutrition, physical activity, and cancer incidence and survival.

Publisher Copyright:
© 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

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