Cancer survivors who sat for extended periods and engaged in little or no leisure-time physical activity had a fivefold higher risk for death from cancer and other causes, according to study results published in JAMA Oncology.
Chao Cao, MPH, of the Washington University School of Medicine in St. Louis, and colleagues explored the impact of daily sitting and leisure-time physical activity on survival outcomes among cancer survivors in the United States. The team took into account all-cause, cancer-specific and noncancer mortality.
The study included 1,535 cancer survivors who participated in the U.S. National Health and Nutrition Examination Survey from 2007 to 2014. The participants were at least 40 years old and were followed for an average of 4.5 years. Daily sitting time and leisure-time physical activity were self-reported. The mean age was 65 years, 60% were women and 83% were white. A majority of the participants had overweight (35%) or obesity (38%).
Of the 1,535 participants, 950 (57%) reported zero minutes of leisure-time physical activity per week, 226 (16%) reported less than 150 minutes per week and 359 (28%) reported 150 minutes or more per week, which is considered adequate according to federal guidelines. In addition, 553 participants (35%) reported sitting for six to eight hours every day, while 328 (25%) said they spent more than eight hours sitting every day. Some 36% reported no leisure-time physical activity along with sitting at least six hours per day.
Over a follow-up period of nine years, there were 293 deaths, including 114 from cancer, 41 from heart disease and 138 from other causes.
Physical activity was linked to a lower risk for all-cause and cancer-specific death compared with no activity. Specifically, multivariable analyses revealed that adequate physical activity was associated with a 66% lower risk for death from all causes and a 68% lower risk for death from cancer compared with inactivity.
Long periods of sitting were also linked to a higher risk for death among cancer survivors. The researchers found that sitting more than eight hours per day was associated with a nearly twofold risk of all-cause death and more than double the risk of cancer-related death compared with sitting less than four hours per day. People who engaged in little or no leisure-time physical activity and sat for more than eight hours per day had the highest overall and cancer-related mortality (5.4-fold and 4.7-fold higher, respectively).
“The findings of this cohort study suggest that the combination of prolonged sitting and lack of physical activity, highly prevalent among U.S. cancer survivors, is associated with heightened risks of mortality outcomes,” wrote the researchers.
Many cancer survivors experience dramatic life changes that can affect their physical and psychological health, contributing to a sedentary lifestyle, they added. Physical inactivity can lead to changes in metabolism, inflammation and immunity, they noted.
These findings suggest that getting enough physical activity through leisure-time pursuits can lead to improved survival, even without strenuous exercise.
Click here to read the study abstract in JAMA Oncology.
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