Abstract
To identify barriers to exercise in Korean colorectal cancer patients and survivors, and to analyze differences in exercise barriers by age, gender, treatment status, and physical activity level. A total of 427 colorectal cancer patients and survivors from different stages and medical status completed a self-administered questionnaire that surveyed their barriers to exercise and exercise participation. The greatest perceived exercise barriers for the sampled population as a whole were fatigue, low level of physical fitness, and poor health. Those under 60-years old reported lack of time (p=0.008), whereas those over 60 reported low level of physical fitness (p=0.014) as greater exercise barriers than their counterparts. Women reported fatigue as a greater barrier than men (p<0.001). Those who were receiving treatment rated poor health (p=0.0005) and cancer-related factors as greater exercise barriers compared to those who were not receiving treatment. A multivariate model found that other demographic and medical status were not potential factors that may affect exercise participation. Further, for those who were not participating in physical activity, tendency to be physically inactive (p<0.001) and lack of exercise skill (p<0.001) were highly significant barriers, compared to those who were participating in physical activity. Also, for those who were not meeting ACSM guidelines, cancer-related exercise barriers were additionally reported (p<0.001), compared to those who were. Our study suggests that fatigue, low level of physical fitness, and poor health are most reported exercise barriers for Korean colorectal cancer survivors and there are differences in exercise barriers by age, sex, treatment status, and physical activity level. Therefore, support for cancer patients should be provided considering these variables to increase exercise participation.
Highlights
The third most diagnosed cancer in men and women in US is colorectal cancer with approximately 142,820 estimated incidence and 50,830 deaths in 2013 (Siegel et al, 2013)
The results of this study are in agreement with the results of previous studies in that fatigue was considered one of the major barriers to exercise in colorectal cancer patients (Courneya et al, 2005; Lynch et al, 2010); the most frequently reported exercise barrier among colorectal cancer patients in a previous study (Courneya et al, 2005) was ‘lack of time/ too busy’
Lynch et al investigated barriers to physical activity among colorectal cancer patients and found that the most frequently reported barrier was ‘already active enough’ (Lynch et al, 2010); their questionnaire was different from ours in that they investigated barriers to ‘physical activity’ while we explored barriers to ‘exercise’, which are clearly different in that exercise requires more regular and structured physical movement with short- and long-term goals (Caspersen et al, 1985)
Summary
The third most diagnosed cancer in men and women in US is colorectal cancer with approximately 142,820 estimated incidence and 50,830 deaths in 2013 (Siegel et al, 2013). A recent article concluded through previous literatures that the effect of physical activity on the cancer risk is stronger for colon cancer than other types of cancers (Kruk and Czerniak, 2013) In this respect, many studies have showed positive impact of exercise and physical activity participation on quality of life and other psychological health of cancer survivors (Cadmus et al, 2009; Courneya et al, 2003; Maryam et al, 2010; Peddle et al, 2008; Shariati et al, 2010; Sherman et al, 2010). Conclusions: Our study suggests that fatigue, low level of physical fitness, and poor health are most reported exercise barriers for Korean colorectal cancer survivors and there are differences in exercise barriers by age, sex, treatment status, and physical activity level. Support for cancer patients should be provided considering these variables to increase exercise participation
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