Physical Activity In Colorectal Cancer Survivors Research Articles

Physical activity maintenance in colorectal cancer survivors after an exercise intervention applying behaviour change techniques: a systematic review and meta-analysis.

The purpose of this systematic review and meta-analysis is to determine the long-term effect of combined physical activity (PA) and behaviour change techniques (BCT) interventions in PA maintenance of colorectal cancer survivors (CRCS) and identify the most frequent BCT implemented in them. PRISMA recommendations were followed. Databases were searched for randomized controlled trials up to October 2023. Studies in which CRCS completed a PA intervention based on any Theoretical Model of Behaviour Change (TMBC) and a subsequent follow-up period were included. Between-group differences at baseline and after follow-up were pooled for meta-analysis. BCT codification was performed using the BCT taxonomy v1. Methodological quality and evidence certainty were also assessed. Five studies involving 906 CRCS met the inclusion criteria. PA interventions applying BCT showed a significant change with a small positive effect (pooled SMD = 0.22 (0.09, 0.35)) on the PA after a follow-up period between 3 and 12months. Twenty-two different BCTs were identified (mean 17.2, range 15-19) of which 12 were common across all interventions. PA and BCT interventions have been found to be effective in improving the long-term maintenance of PA in CRCS. Further studies with higher methodological quality are needed to confirm these findings. Aerobic exercise, pedometers, PA diaries and educational materials seem to be important aspects to achieve sustainable adherence to an active lifestyle over time. Supervision, access to fitness areas and applying some BCT appear to be differentiating features to obtain more successful PA maintenance.

Abstract 107: Self-Reported Physical Activity Patterns among Colorectal Cancer Survivors in Egypt

Abstract Purpose: Compared to the U.S., colorectal cancer (CRC) in Egypt is more prevalent among younger individuals (under age 40) and diagnosed at an advanced stage leading to higher mortality rates. Given these higher mortality rates, focusing on tertiary prevention strategies, such as physical activity, is warranted. Our study purpose was to assess physical activity behavior in colorectal cancer survivors living in Egypt. Methods: Egyptian study staff recruited 86 participants from the Alexandria University Oncology Department. Eligible participants were post-primary or currently undergoing treatment for CRC. Study staff administered the World Health Organization physical activity questionnaire (GPAQ; www.who.int/chp/steps/GPAQ/en/) and Godin Leisure-Time Exercise Questionnaire (GLTEQ). Both assessments were translated into Arabic. Results: The median age of study participants was 52 years old with 43% being male, 64% reporting early stage cancer, 77% reporting one or more years of school, and 79% living in an urban location. Most participants (76%) had a normal or overweight BMI. According to the GPAQ, the median total MET mins/wk for participants was 1440 with interquartile range of 225 to 6720; 63% of participants met the GPAQ WHO recommendations of ≥600 MET mins/wk. Occupational and transportation contributed to the majority of total MET mins/wk. According to the GLTEQ, the median for weekly minutes of ≥moderate intensity physical activity was 0 with interquartile range of 0 to 23 minutes per week. Only 14% were meeting physical activity recommendations of ≥150 weekly minutes of ≥moderate intensity physical activity based on the GLTEQ. Conclusion: The prevalence of meeting physical activity recommendations varies depending on measurement tool used. Considering sources of physical activity beyond recreational alone is important for more fully understanding physical activity behavior. The low levels of recreational or leisure exercise provides an opportunity for increasing the prevalence of sufficient physical activity in CRC survivors in Egypt. Citation Format: Salma Mohamed Aly, Doaa Genena, James Shikany, Lori Brand Bateman, Mona Fouad, Waleed Arafat, Salah-Eldin Abdelmoneim, Sejong Bae, Isabel Scarinci, Marwa Hussein, Miriam A. Zaki, Somaia Khamess, Laura Q. Rogers. Self-Reported Physical Activity Patterns among Colorectal Cancer Survivors in Egypt [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 107.

The physical activity of colorectal cancer survivors during chemotherapy : Based on the theory of planned behavior.

The purpose of this study was to investigate the physical activity (PA) of colorectal cancer (CRC) survivors during chemotherapy and to explain it based on the theory of planned behavior (TPB). In addition, the effects of planning, past physical activity (P-PA), and self-efficacy on the PA of CRC survivors were analyzed. CRC survivors were recruited in a third-grade hospital of Changchun via a convenience sampling method. All survivors were asked to complete self-report questionnaires assessing medical and demographic variables, PA, constructs from the TPB, P-PA, planning, and self-efficacy. A total of 174 CRC survivors were included in this study. Only 7.5% (13) of these CRC survivors had sufficient PA, and 32.2% (56) of CRC survivors were completely sedentary. Gender, education level, working status, residential location, method of payment for medical expenses, and cancer stage were all associated with PA in these patients (P < 0.05). The path model was able to explain 54% (R2 = 0.54) of the PA variance in these CRC survivors. P-PA had the greatest impact on PA during chemotherapy, and P-PA affected PA both directly and indirectly through planning. Insufficient PA in CRC survivors was associated with a variety of factors, with P-PA having the greatest impact on this outcome. The results of this study suggest that attention must be paid to survivors who had exhibited insufficient PA prior to initial diagnosis.

Effects of a 12-week home-based exercise program on quality of life, psychological health, and the level of physical activity in colorectal cancer survivors: a randomized controlled trial.

To examine the effects of a home-based exercise program on quality of life (QOL), psychological health, and the level of physical activity (PA) in colorectal cancer survivors. Seventy-one colorectal cancer survivors were randomized into either a home-based exercise group (N = 37) or control group (N = 34). The home-based exercise program included unsupervised walking, stationary bike, or swimming for aerobic exercise, as well as resistance exercise DVDs, a pedometer, and an exercise log. The Functional Assessment of Cancer Therapy-Colorectal, Functional Assessment of Chronic Illness Therapy-Fatigue Scale, patient health questionnaire, and Godin Leisure-Time Exercise Questionnaire were used to assess QOL, fatigue, depression, and PA levels. Among the 71 participants, 30 in the exercise group and 28 in the control group completed the study. The change in the QOL between the intervention and control groups was insignificant. However, QOL was significantly improved in the exercise group (QOL, p = 0.024). Sub-domain of QOL, emotional well-being, and trial outcome index-physical/functional/colorectal (p = 0.015 and p = 0.035, respectively) were improved in the exercise group. The level of PA was significantly increased after 12weeks in the exercise group (97.0 ± 188.5 vs. 332.6 ± 306.1, p < 0.001), and the change significantly differed compared with the control group (mean change 235.6 vs. 16.3, p < 0.001). The home-based exercise program may improve the QOL and psychological health in colorectal cancer survivors. We have demonstrated that the home-based exercise program was effective in increasing the level of PA in colorectal cancer survivors.

The insulin-like growth factor axis: A biological mechanism linking physical activity to colorectal cancer survival

Physical activity (PA) is related to colorectal cancer (CRC) mortality, with approximately 15% of CRC deaths worldwide attributable to physical inactivity. Moreover, higher levels of PA in CRC survivors have been associated with a reduced risk of the disease recurring. Despite the recognised nexus between PA and the risk of CRC, the physiological mechanisms underlying the inverse relationship between PA and mortality following CRC diagnosis are less apparent, with evidence primarily drawn from epidemiological studies. The insulin-like growth factor (IGF) axis plays a central role in cellular growth, proliferation regulation, differentiation and apoptosis. Specifically, high levels of insulin-like growth factor 1 (IGF-1) have been consistently linked to the severity of CRC tumours. Further, insulin-like growth factor binding protein 3 (IGFBP-3) regulates the bioavailability of IGF-I and therefore plays a central role in CRC prognosis. Decreasing levels of IGF-1 and increasing levels of IGFBP-3 may thus be a plausible mechanism underlying the inverse association between PA and CRC survival.

Identification and Evaluation of the Salient Physical Activity Beliefs of Colorectal Cancer Survivors

Physical activity (PA) has been associated with lower risk of disease recurrence and longer survival in colorectal cancer (CRC) survivors; however, less than one-third of CRC survivors are meeting PA guidelines. Interventions to promote PA in CRC survivors need to understand the most critical beliefs that influence PA behavior. The objective of this study was to examine the strength of associations between the most common PA beliefs of CRC survivors and motivational constructs from the Theory of Planned Behavior (TPB) as well as PA behavior. Colorectal cancer survivors (n = 600) residing in Alberta, Canada, completed self-report questionnaires assessing medical and demographic variables, PA beliefs, constructs from the TPB, and PA behavior. Colorectal cancer survivors identified improved fitness (69.5%), family members (67.3%), and medical/health problems (8.8%) as the most prevalent behavioral, normative, and control beliefs, respectively. All PA beliefs were significantly correlated with all TPB constructs and PA. Physical activity interventions for CRC survivors should target many salient beliefs including behavioral, normative, and control beliefs. Insights into the salient beliefs for PA in CRC survivors can guide nurses in developing successful strategies to promote PA in this population and likely improve quality of life and possibly disease outcomes.

Sport participation in colorectal cancer survivors: an unexplored approach to promoting physical activity

Physical activity improves health outcomes in colorectal cancer (CRC) survivors, but participation rates are low. One understudied strategy for increasing physical activity in CRC survivors may be sport participation. Here, we report the sport participation rate, sport preferences, and correlates of sport participation among CRC survivors. A provincial, population-based mailed survey of CRC survivors in Alberta, Canada was performed and included measures of sport participation, sport preferences, sport benefits and barriers, and medical and demographic variables. A total of 600 CRC survivors completed the survey (34 % response rate). Almost a quarter (23.0 %) of CRC survivors reported participating in a sport in the past month, with the most common sport being golf (58.7 %). In multivariate regression analysis, 33.0 % (p = 0.001) of the variance in sport participation was explained by being male (β = 0.12; p = 0.006), in better general health (β = 0.12; p = 0.006), and ≥ 5 years post-diagnosis (β = 0.09; p = 0.031). The most common barriers to sport participation were time, age/agility, and no interest/dislike of sports. The most common anticipated benefits of sport participation were improved physical fitness, meeting people, and improved health. Over half (57.2 %) of CRC survivors were possibly interested in learning about sport participation opportunities. Promotion of sport participation may be a potentially fruitful strategy for increasing physical activity in CRC survivors.