Physical activity, sitting time, and global mental and physical health among cancer survivors vs. cancer-free older adults

Authors: Rees-Punia E, Patel AV, Nocera JR, Chantaprasopsuk S, Demark-Wahnefried W, Leach CR, Smith TG, Gapstur SM

Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020

Abstract Body:
Purpose: Few studies examine associations of moderate-to-vigorous physical activity (MVPA) and sitting time with quality of life in cancer survivors compared to a cancer-free group. This study examined differences in global mental and physical health (GMH, GPH) across levels of MVPA and sitting time among cancer survivors and cancer-free participants of similar age. Methods: Cancer Prevention Study-II Nutrition Cohort participants (59.9% women, age 77.8±5.8 years) were grouped as: 1) cancer survivors 1-5 years post-diagnosis (n=3,718), 2) cancer survivors 6-10 years post-diagnosis (n=4,248), and 3) cancer-free adults (n=69,857). All participants completed the Patient-Reported Outcomes Measurement Information System® GMH and GPH measures and self-reported MVPA and sitting time in 2009. Mean differences in GMH and GPH t-scores across levels of MVPA (none, 0- <7.5, 7.5-<15, 15-<22.5, 22.5+ Metabolic Equivalent [MET]-hours/week) and sitting time (0-<3, 3-<6, 6+ hours/day) were assessed using generalized linear models adjusted for age, sex, race/ethnicity, education, comorbidities, smoking, and body mass index. Results: Mean GMH and GPH were statistically significantly higher in cancer-free participants compared to survivors, though differences were not clinically meaningful (GMH mean difference = 0.52, 95% Confidence Interval [CI] = 0.24-0.79, GPH mean difference = 0.87, 95% CI = 0.60-1.16). However, higher volume of MVPA was associated with higher GMH and GPH for all three groups (p-trends<0.001), and differences between the least and most active were clinically meaningful. For example, among long-term survivors, those with no MVPA (n=1,039) averaged 47.04 in GMH and 43.99 in GPH, while those with 22.5+ MET- hr/wk (n=601) averaged 52.49 and 51.31 for GMH and GPH after covariate adjustment. Similarly, lower duration of sitting time was associated with higher GMH and GPH for all groups (p-trends<0.001), with clinically meaningful differences between the least and most sedentary. Results were not significantly different when excluding those dying within one year of their survey date. Conclusions: These findings provide evidence for the importance of increased MVPA and decreased sitting time for improved health in older adults with or without a prior cancer diagnosis.

Keywords: physical activity, global health, survivors