TY - JOUR
T1 - Physical activity patterns after diagnosis and survival of prognostic colorectal cancer subgroups
AU - Smit, Karel C
AU - Derksen, Jeroen W G
AU - van Lanen, Anne-Sophie
AU - Wesselink, Evertine
AU - Belt, Eric J Th
AU - Berbée, Maaike
AU - Balen, Marissa Cloos-Van
AU - Dekker, Jan Willem T
AU - van Dodewaard, Joyce M
AU - Douma, Joeri
AU - de Groot, Jan Willem
AU - Van Halteren, Henk K
AU - Hendriks, Mathijs P
AU - de Hingh, Ignace H J T
AU - Houtsma, Danny
AU - Janssen, Johan J B
AU - Konsten, Joop L M
AU - Los, Maartje
AU - Sie, Mark P S
AU - Sommeijer, Dirkje
AU - Tanis, Pieter J
AU - van der Velden, Ankie
AU - Iersel, Liselot Valkenburg-Van
AU - Vles, Wouter J
AU - de Wilt, Johannes H W
AU - Kok, Dieuwertje E
AU - Kampman, Ellen
AU - van Duijnhoven, Fränzel J B
AU - Koopman, Miriam
AU - May, Anne M
N1 - Publisher Copyright:
© The Author(s) 2025. Published by Oxford University Press.
PY - 2026/2
Y1 - 2026/2
N2 - Background Physical activity (PA) is associated with improved overall survival (OS) among colorectal cancer (CRC) patients, but research on PA changes after diagnosis remains limited. This study examines associations between OS and changes in PA from CRC diagnosis onward, across stage- and treatment-related subgroups. Methods Data were analyzed from patients in two large CRC cohorts (PLCRC and COLON) enrolled between August 2010 and December 2022 (follow-up until February 1st, 2024). This included 3395 stage I–IIA patients who underwent surgery only, 2406 stage IIB/C–III patients who received (neo-)adjuvant therapy, and 669 metastatic CRC (mCRC) patients. PA was assessed via the validated SQUASH questionnaire at diagnosis (T0), and at 6, 12, and 24months post-diagnosis (T6 to T24). Moderate-to-vigorous-intensity recreational activity was quantified by calculating Metabolic Equivalent of Task (MET) hours per week. Associations with OS were examined for change (active [tertile 2 and 3] vs inactive [tertile 1]) between timepoints using multivariable Cox proportional hazards models. Results Among surgery-only patients, change from inactivity to activity between T0 and T6 was significantly associated with OS (HR = 0.58, 95% CI = 0.35 to 0.96). For (neo-)adjuvantly treated patients, significant associations were observed between T6 and T12 (HR = 0.53, 95% CI = 0.31 to 0.90). Among mCRC patients, a significant association was observed between T6 and T12 (HR = 0.53, 95% CI = 0.29 to 0.99). Conclusion Changing from inactivity to activity is significantly associated with prolonged survival during the early months post-diagnosis for surgery-only CRC patients, and later for those undergoing (neo-)adjuvant therapy or with metastatic disease. Validation is warranted in interventional studies.
AB - Background Physical activity (PA) is associated with improved overall survival (OS) among colorectal cancer (CRC) patients, but research on PA changes after diagnosis remains limited. This study examines associations between OS and changes in PA from CRC diagnosis onward, across stage- and treatment-related subgroups. Methods Data were analyzed from patients in two large CRC cohorts (PLCRC and COLON) enrolled between August 2010 and December 2022 (follow-up until February 1st, 2024). This included 3395 stage I–IIA patients who underwent surgery only, 2406 stage IIB/C–III patients who received (neo-)adjuvant therapy, and 669 metastatic CRC (mCRC) patients. PA was assessed via the validated SQUASH questionnaire at diagnosis (T0), and at 6, 12, and 24months post-diagnosis (T6 to T24). Moderate-to-vigorous-intensity recreational activity was quantified by calculating Metabolic Equivalent of Task (MET) hours per week. Associations with OS were examined for change (active [tertile 2 and 3] vs inactive [tertile 1]) between timepoints using multivariable Cox proportional hazards models. Results Among surgery-only patients, change from inactivity to activity between T0 and T6 was significantly associated with OS (HR = 0.58, 95% CI = 0.35 to 0.96). For (neo-)adjuvantly treated patients, significant associations were observed between T6 and T12 (HR = 0.53, 95% CI = 0.31 to 0.90). Among mCRC patients, a significant association was observed between T6 and T12 (HR = 0.53, 95% CI = 0.29 to 0.99). Conclusion Changing from inactivity to activity is significantly associated with prolonged survival during the early months post-diagnosis for surgery-only CRC patients, and later for those undergoing (neo-)adjuvant therapy or with metastatic disease. Validation is warranted in interventional studies.
U2 - 10.1093/jncics/pkaf116
DO - 10.1093/jncics/pkaf116
M3 - Article
C2 - 41396674
SN - 2515-5091
VL - 10
JO - JNCI cancer spectrum
JF - JNCI cancer spectrum
IS - 1
M1 - pkaf116
ER -