Abstract
The 2003–2004 and 2005–2006 cycles of the National Health and Nutrition Examination Survey (NHANES) were among the first population-level studies to incorporate objectively measured physical activity and sedentary behavior, allowing for greater understanding of these behaviors. However, there has yet to be a comprehensive examination of these data in cancer survivors, including short- and long-term survivors of all cancer types. Therefore, the purpose of this analysis was to use these data to describe activity behaviors in short- and long-term cancer survivors of various types. A secondary aim was to compare activity patterns of cancer survivors to that of the general population. Cancer survivors (n = 508) and age-matched individuals not diagnosed with cancer (n = 1,016) were identified from a subsample of adults with activity measured by accelerometer. Physical activity and sedentary behavior were summarized across cancer type and demographics; multivariate regression was used to evaluate differences between survivors and those not diagnosed with cancer. On average, cancer survivors were 61.4 (95% CI: 59.6, 63.2) years of age; 57% were female. Physical activity and sedentary behavior patterns varied by cancer diagnosis, demographic variables, and time since diagnosis. Survivors performed 307 min/day of light-intensity physical activity (95% CI: 295, 319), 16 min/day of moderate-vigorous intensity activity (95% CI: 14, 17); only 8% met physical activity recommendations. These individuals also reported 519 (CI: 506, 532) minutes of sedentary time, with 86 (CI: 84, 88) breaks in sedentary behavior per day. Compared to non-cancer survivors, after adjustment for potential confounders, survivors performed less light-intensity activity (P = 0.01), were more sedentary (P = 0.01), and took fewer breaks in sedentary time (P = 0.04), though there were no differences in any other activity variables. These results suggest that cancer survivors are insufficiently active. Relative to adults of similar age not diagnosed with cancer, they engage in more sedentary time with fewer breaks. As such, sedentary behavior and light-intensity activity may be important intervention targets, particularly for those for whom moderate-to-vigorous activity is not well accepted.
Highlights
In the last few decades, much work has been dedicated to the study of physical activity in cancer survivorship [1,2,3,4]
We explored the differences between cancer survivors and age-matched non-cancer survivors with respect to meeting physical activity guidelines and time spent in various physical activity and sedentary behavior categories
Accelerometer-derived physical activity and sedentary time by cancer type compared to non-cancer survivors (average age: 62.3; 48% female), cancer survivors were more likely to be female (P < 0.001), non-Hispanic White (P < 0.001), and more likely to be current smokers (P < 0.05)
Summary
In the last few decades, much work has been dedicated to the study of physical activity in cancer survivorship [1,2,3,4]. Sedentary behavior has gained increased attention as a health behavior distinct from physical inactivity and as a potential independent predictor of health outcomes [8,9,10,11]. Sedentary behavior includes any waking activity that is performed while sitting or reclining that does not substantially increase energy expenditure [12]. Prolonged sedentary behavior may be associated with increased prostate, colorectal, endometrial, and ovarian cancer risk, cancer mortality in women, as well as weight gain and BMI in breast and colorectal cancer survivors [13,14]. The putative mechanisms underlying these associations include the potential for excess sedentary time to promote weight gain and obesity, insulin dysregulation, and lowgrade chronic inflammation [13]
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