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Prediagnostic Physical Activity and Colorectal Cancer Survival: Overall and Stratified by Tumor Characteristics.

ABSTRACT: Physical activity is associated with a lower incidence of colorectal cancer; however, the relationship of physical activity with colorectal cancer survival is not yet clear. We evaluated the association between prediagnostic physical activity and colorectal cancer survival, overall and accounting for tumor markers associated with colorectal cancer survival: BRAF and KRAS mutation status and microsatellite instability (MSI) status.Participants were 20- to 74-year-old colorectal cancer patients diagnosed between 1998 and 2007 from the population-based Seattle Colon Cancer Family Registry (S-CCFR). Self-reported physical activity in the years preceding colorectal cancer diagnosis was summarized as average metabolic equivalent task hours per week (MET-h/wk; n = 1,309). Somatic BRAF and KRAS mutations and MSI status were evaluated on a subset of patients (n = 1043). Cox regression was used to estimate HRs and 95% confidence intervals (CI) for overall and disease-specific survival after adjusting for relevant confounders. Stratified analyses were conducted across categories of BRAF, KRAS, and MSI, as well as tumor stage and site.Higher prediagnostic recreational physical activity was associated with significantly more favorable overall survival (HR for highest vs. lowest category, 0.70; 95% CI, 0.52-0.96); associations were similar for colorectal cancer-specific survival. Results consistently indicated a favorable association with physical activity across strata defined by tumor characteristics.Individuals who were physically active before colorectal cancer diagnosis experienced better survival than those who were inactive or minimally active.Our results support existing physical activity recommendations for colorectal cancer patients and suggest that the beneficial effect of activity is not specific to a particular molecular phenotype of colorectal cancer.

SUBMITTER: Hardikar S

PROVIDER: S-EPMC4491038 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Prediagnostic Physical Activity and Colorectal Cancer Survival: Overall and Stratified by Tumor Characteristics.

Hardikar Sheetal S Newcomb Polly A PA Campbell Peter T PT Win Aung Ko AK Lindor Noralane M NM Buchanan Daniel D DD Makar Karen W KW Jenkins Mark A MA Potter John D JD Phipps Amanda I AI

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20150514 7

<h4>Background</h4>Physical activity is associated with a lower incidence of colorectal cancer; however, the relationship of physical activity with colorectal cancer survival is not yet clear. We evaluated the association between prediagnostic physical activity and colorectal cancer survival, overall and accounting for tumor markers associated with colorectal cancer survival: BRAF and KRAS mutation status and microsatellite instability (MSI) status.<h4>Methods</h4>Participants were 20- to 74-yea ...[more]

PMID: 25976417

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Project description:Physical activity (PA) is known to reduce breast cancer (BC) risk and improve patient prognosis. However, the association between pre-diagnostic PA and the aggressiveness of BC is unclear. We investigated the associations between PA, BC tumour characteristics, and survival. This retrospective observational study included 7688 BC patients from the Singapore Breast Cancer Cohort (2010-2016). PA information from the questionnaire included intensity (light/moderate/vigorous) and duration (<1 h/1-2 h/>2 h per week). A PA score (1-5) incorporating intensity and duration was calculated. Associations between PA score and tumour characteristics such as stage, histological grade, nodal and hormone receptor status were examined using multinomial regression. Moreover, 10-year overall survival was estimated using Cox regression analysis in 6572 patients after excluding patients with invalid survival data and stage IV disease. Breast tumours associated with higher PA score were more likely to be non-invasive (ORinvasive&nbsp;vs.&nbsp;non-invasive(reference) [95% CI]: 0.71 [0.58-0.87], p-trend = 0.001), of lower grade (ORpoorly&nbsp;vs.&nbsp;well differentiated(reference): 0.69 [0.52-0.93], p = 0.014), ER-positive (ORER-negative&nbsp;vs.&nbsp;ER-positive(reference): 0.94 [0.89-1.00], p-trend = 0.049), PR-positive (ORPR-negative&nbsp;vs.&nbsp;PR-positive(reference): 0.82 [0.67-0.99], p = 0.041), HER2-negative (ORHER2-negative&nbsp;vs.&nbsp;HER2-positive(reference): 1.29 [1.02-1.62], p-trend = 0.002), and less likely to be of HER2-overexpressed subtype (ORHER2-overexpressed&nbsp;vs.&nbsp;Luminal A(reference): 0.89 [0.81-0.98], p-trend = 0.018). These associations (odds ratios) were more pronounced among post-menopausal patients. A higher PA score did not improve survival. Higher levels of pre-diagnostic PA were associated with less aggressive tumours in BC patients. This illustrated another benefit of PA in addition to its known role in BC risk reduction.

Dataset Information

Prediagnostic Physical Activity and Colorectal Cancer Survival: Overall and Stratified by Tumor Characteristics.

Publications

Prediagnostic Physical Activity and Colorectal Cancer Survival: Overall and Stratified by Tumor Characteristics.

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