Abstract
PurposeThe number of cancer survivors has risen substantially due to improvements in early diagnosis and treatment. Health behaviours such as physical activity (PA) and diet can reduce recurrence and mortality, and alleviate negative consequences of cancer and treatments. Digital behaviour change interventions (DBCIs) have the potential to reach large numbers of cancer survivors.MethodsWe conducted a systematic review and meta-analyses of relevant studies identified by a search of Medline, EMBASE, PubMed and CINAHL. Studies which assessed a DBCI with measures of PA, diet and/or sedentary behaviour were included.ResultsFifteen studies were identified. Random effects meta-analyses showed significant improvements in moderate-vigorous PA (seven studies; mean difference (MD) = 41 min per week; 95% CI 12, 71) and body mass index (BMI)/weight (standardised mean difference (SMD) = −0.23; 95% CI −0.41, −0.05). There was a trend towards significance for reduced fatigue and no significant change in cancer-specific measures of quality of life (QoL). Narrative synthesis revealed mixed evidence for effects on diet, generic QoL measures and self-efficacy and no evidence of an effect on mental health. Two studies suggested improved sleep quality.ConclusionsDBCIs may improve PA and BMI among cancer survivors, and there is mixed evidence for diet. The number of included studies is small, and risk of bias and heterogeneity was high. Future research should address these limitations with large, high-quality RCTs, with objective measures of PA and sedentary time.Implications for cancer survivorsDigital technologies offer a promising approach to encourage health behaviour change among cancer survivors.
Highlights
Over 14 million people are diagnosed with cancer worldwide each year, and this is expected to rise to 22 million over the two decades [1]
While this study reported that 35% of breast cancer survivors were meeting guidelines, another study which used accelerometers to measure physical activity (PA) objectively found that this can be as low as 16% and those with highest levels of comorbidities were the least active [39]
The primary objective of this study was to perform a systematic review and meta-analysis of health behaviour interventions using digital technologies in cancer survivors in order to assess their efficacy in promoting PA, reducing sedentary behaviour or improving dietary quality
Summary
Over 14 million people are diagnosed with cancer worldwide each year, and this is expected to rise to 22 million over the two decades [1]. In 2012, globally there were 32 million people living beyond 5 years of diagnosis [2] and in the UK, half of people diagnosed with cancer will survive for more than 10 years [3]. Long-term negative consequences of cancer and treatment related side-effects are common and often debilitating. Macmillan Cancer Support, a UK cancer charity, estimates that more than 70% of cancer survivors in the UK (~1.8 million people) are living with at least one other long-term comorbidity [13]. There is emerging evidence to suggest that cancer treatment can leave survivors at greater risk for developing these conditions (e.g. due to cardiovascular toxicity of cancer therapy [15]). There is strong impetus to develop interventions that improve long-term outcomes for cancer survivors
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