ASPO Abstracts
Associations of physical activity and BMI with survival and recurrence in stage I-III colorectal cancer patients: Results from the ColoCare Study
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2022
Abstract Body:
Purpose of the study: While physical activity and BMI have been studied individually in the context of cancer survivorship, it remains unknown whether physical activity can mitigate the impact of BMI on colorectal cancer survival. The objective of this study is to investigate joint associations and changes of physical activity and BMI during the first year after diagnosis on colorectal cancer survival and recurrence.Methods: N=938 stage I-III colorectal cancer patients were recruited into the international, multi-center ColoCare Study. Recreational physical activity levels at baseline (pre-surgery) and 12 months post-surgery were assessed using an adapted version of the IPAQ questionnaire and computed into metabolic equivalent per task hours/week (MET hrs/wk). Patients were classified into inactive (<8.75 MET hrs/wk) and active (‚â•8.75 MET hrs/wk). BMI (kg/m2) at baseline and 12 months post-surgery was categorized into normal weight (BMI: ‚â•18 and <25 kg/m2), overweight (BMI: ‚â•25 and <30 kg/m2), and obese (BMI: ‚â•30 kg/m2). Patients were further grouped into joint physical activity and BMI groups. Cox proportional hazard models were used to evaluate associations of physical activity and BMI groups, as well as changes in physical activity and BMI from baseline to 12 months post-surgery with overall and recurrence-free survival. Models were adjusted for age, sex, race, stage at diagnosis, and adjuvant treatment. Results: The study population was primarily male (56%) and 13% were non-White participants. A significant proportion was diagnosed with stage III disease (49%) and colon cancer (52%) and classified as overweight or obese/inactive (40%). Overweight/active [HR: 2.28 (95% CI: 1.10-4.87), p=0.03], overweight/inactive [2.04 (1.00-4.31), p=0.06], and obese/inactive [2.20 (1.10-4.60), p=0.04] patients had an increased risk of dying as compared to normal weight/active patients. Each 1 MET hrs/wk increased change from baseline to 12 months post-surgery was associated with a 3% decreased risk in recurrence (p=0.001).Conclusions: Our results support the importance of promoting physical activity guidelines during the first year after diagnosis in colorectal cancer patients. It warrants further investigation of the obesity paradox in colorectal cancer survivorship.
Keywords: colorectal cancer, energy balance, survivorship