Physical Activity In Colorectal Cancer Patients 12 Months After Resection: Results From The Colocare Study

Abstract

While several studies have objectively measured physical activity (PA) and sedentary behavior (SB) in colorectal cancer survivors, the time between cancer diagnosis and accelerometer wear within these studies was highly variable. PURPOSE: To quantify PA and SB in colorectal cancer survivors at a fixed time-point (12 months) after primary tumor resection. METHODS: The ColoCare Study is an international, longitudinal, prospective cohort study in newly-diagnosed colorectal cancer patients that collects questionnaires and biospecimens at regular intervals from diagnosis to 5 years post-resection. For this analysis, participants with stage I-III colorectal cancer from the German Cancer Research Center (DKFZ, Heidelberg, Germany) and the Huntsman Cancer Institute (HCI, Salt Lake City, UT) were provided an Actigraph GT3X+ accelerometer 12 months after primary resection and asked to wear the monitor 24 hours per day for 4+ consecutive days. PA volume and intensity were derived from raw accelerometer data using ActiLife software (v6.16.3) and Freedson (1998) activity cut-points. Pearson correlations were used to evaluate associations between PA, SB, and clinicodemographic characteristics (e.g. BMI). RESULTS: Sixty-eight ColoCare participants (DKFZ n=43; HCI n=25) met valid accelerometer wear criteria (>10 h/day for 4+ days) at the 12 month time-point and were thus included in analysis. Participants spent 8.2 ± 5.8% of monitor wear time in moderate-to-vigorous physical activity (MVPA) and 73.3 ± 9.7% of monitor wear time sedentary. Additionally, participants accrued 168 ± 243 weekly exercise minutes (MVPA in bouts >10 minutes) and 38% were meeting the PA guidelines. Participants enrolled at HCI were significantly more active than those enrolled at the DKFZ (Steps/day: 10,008 ± 2,947 vs.6,188 ± 3,815, p<0.05) and those patients who did not receive adjuvant chemotherapy were more active than those who underwent chemotherapy (Steps/day: 8,585 ± 4,160 vs. 6,350 ± 3,349; p<0.05). CONCLUSIONS: PA levels 12 months after primary colorectal cancer resection were greater than expected, and may be influenced by geographic location and adjuvant chemotherapy use. Supported by the ACSM Paffenbarger-Blair Fund for Physical Activity Epidemiology, the Lackas Foundation, and NIH U01 CA206110