Determinants of Physical Activity among Patients with Colorectal Cancer: From Diagnosis to 5 Years after Diagnosis

Karel C Smit; Jeroen W G Derksen; Rebecca K Stellato; Anne-Sophie VAN Lanen; Evertine Wesselink; Eric J Th Belt; Marissa Cloos-VAN Balen; Peter Paul L O Coene; Jan Willem T Dekker; Jan Willem DE Groot; Annebeth W Haringhuizen; Henk K VAN Halteren; Tjarda T VAN Heek; Helgi H Helgason; Mathijs P Hendriks; Ignace H J T DE Hingh; Ronald Hoekstra; Danny Houtsma; Johan J B Janssen; Niels Kok; Joop L M Konsten; Maartje Los; Martijn R Meijerink; Leonie J M Mekenkamp; Koen C M J Peeters; Marco B Polée; Ron C Rietbroek; Anandi H W Schiphorst; Ruud W M Schrauwen; Jennifer Schreinemakers; Mark P S Sie; Lieke Simkens; Eric J A Sonneveld; Frederiek Terheggen; Liselot Valkenburg-VAN Iersel; Wouter J Vles; Daria K Wasowicz-Kemps; Johannes H W DE Wilt; Dieuwertje E Kok; Renate M Winkels; Ellen Kampman; Fränzel J B VAN Duijnhoven; Miriam Koopman; Anne M May

doi:10.1249/MSS.0000000000003351

Determinants of Physical Activity among Patients with Colorectal Cancer: From Diagnosis to 5 Years after Diagnosis

Med Sci Sports Exerc. 2024 Apr 1;56(4):623-634. doi: 10.1249/MSS.0000000000003351. Epub 2023 Nov 27.

Authors

Karel C Smit¹, Jeroen W G Derksen¹, Rebecca K Stellato², Anne-Sophie VAN Lanen³, Evertine Wesselink³, Eric J Th Belt⁴, Marissa Cloos-VAN Balen⁵, Peter Paul L O Coene⁶, Jan Willem T Dekker⁷, Jan Willem DE Groot⁸, Annebeth W Haringhuizen⁹, Henk K VAN Halteren¹⁰, Tjarda T VAN Heek¹¹, Helgi H Helgason¹², Mathijs P Hendriks¹³, Ignace H J T DE Hingh¹⁴, Ronald Hoekstra¹⁵, Danny Houtsma¹⁶, Johan J B Janssen¹⁷, Niels Kok¹⁸, Joop L M Konsten¹⁹, Maartje Los²⁰, Martijn R Meijerink²¹, Leonie J M Mekenkamp²², Koen C M J Peeters²³, Marco B Polée²⁴, Ron C Rietbroek²⁵, Anandi H W Schiphorst²⁶, Ruud W M Schrauwen²⁷, Jennifer Schreinemakers²⁸, Mark P S Sie²⁹, Lieke Simkens³⁰, Eric J A Sonneveld³¹, Frederiek Terheggen³², Liselot Valkenburg-VAN Iersel³³, Wouter J Vles³⁴, Daria K Wasowicz-Kemps³⁵, Johannes H W DE Wilt³⁶, Dieuwertje E Kok³, Renate M Winkels³, Ellen Kampman³, Fränzel J B VAN Duijnhoven³, Miriam Koopman³⁷, Anne M May¹

Affiliations

¹ Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS.
² Department of Data Science and Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS.
³ Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS.
⁴ Department of Surgery, Albert Schweitzer Hospital, Dordrecht, THE NETHERLANDS.
⁵ Department of Medical Oncology, Groene Hart Hospital, Gouda, THE NETHERLANDS.
⁶ Department of Surgery, Maasstad Hospital, Rotterdam, THE NETHERLANDS.
⁷ Department of Surgery, Reinier de Graaf Hospital, Delft, THE NETHERLANDS.
⁸ Department of Medical Oncology, Isala Hospital, Zwolle, THE NETHERLANDS.
⁹ Department of Medical Oncology, Ziekenhuis Gelderse Vallei, Ede, THE NETHERLANDS.
¹⁰ Department of Medical Oncology, Admiraal de Ruyter Hospital, Goes, THE NETHERLANDS.
¹¹ Department of Surgery, Ziekenhuis Gelderse Vallei, Ede, THE NETHERLANDS.
¹² Department of Medical Oncology, Haaglanden Medical Center, Den Haag, THE NETHERLANDS.
¹³ Department of Medical Oncology, Northwest Clinics, Alkmaar, THE NETHERLANDS.
¹⁴ Department of Surgery, Catharina Hospital, Eindhoven, THE NETHERLANDS.
¹⁵ Department of Medical Oncology, Ziekenhuisgroep Twente, Hengelo, THE NETHERLANDS.
¹⁶ Department of Medical Oncology, Haga Hospital, Den Haag, THE NETHERLANDS.
¹⁷ Department of Medical Oncology, Canisius Wilhelmina Hospital, Nijmegen, THE NETHERLANDS.
¹⁸ Department of Gastrointestinal Oncology, Antoni Van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS.
¹⁹ Department of Surgery, Viecuri Hospital, Venlo, THE NETHERLANDS.
²⁰ Department of Medical Oncology, St. Antonius Hospital, Nieuwegein, THE NETHERLANDS.
²¹ Department of Radiology and Nuclear Medicine, VU Medical Center, Amsterdam, THE NETHERLANDS.
²² Department of Medical Oncology, Medisch Spectrum Twente, Enschede, THE NETHERLANDS.
²³ Department of Surgery, Leiden University Medical Center, University of Leiden, Leiden, THE NETHERLANDS.
²⁴ Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, THE NETHERLANDS.
²⁵ Department of Medical Oncology, Rode Kruis Hospital, Beverwijk, THE NETHERLANDS.
²⁶ Department of Surgery, Diakonessenhuis Hospital, Utrecht, THE NETHERLANDS.
²⁷ Department of Gastroenterology and Hepatology, Bernhoven Hospital, Uden, THE NETHERLANDS.
²⁸ Department of Surgery, Amphia Hospital, Breda, THE NETHERLANDS.
²⁹ Department of Medical Oncology, ZorgSaam Hospital, Terneuzen, THE NETHERLANDS.
³⁰ Department of Medical Oncology, Maxima Medical Center, Eindhoven, THE NETHERLANDS.
³¹ Department of Surgery, Dijklander Hospital, Hoorn, THE NETHERLANDS.
³² Department of Medical Oncology, Bravis Hospital, Roosendaal, THE NETHERLANDS.
³³ Maastricht University Medical Center, Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University, Maastricht, THE NETHERLANDS.
³⁴ Department of Surgery, Ikazia Hospital, Rotterdam, THE NETHERLANDS.
³⁵ Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, THE NETHERLANDS.
³⁶ Department of Surgery, Radboud University Medical Center, University of Nijmegen, Nijmegen, THE NETHERLANDS.
³⁷ Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS.

PMID: 38079324
DOI: 10.1249/MSS.0000000000003351

Abstract

Introduction: Physical activity (PA) is associated with higher quality of life and probably better prognosis among colorectal cancer (CRC) patients. This study focuses on determinants of PA among CRC patients from diagnosis until 5 yr postdiagnosis.

Methods: Sociodemographic and disease-related factors of participants of two large CRC cohort studies were combined. Moderate-to-vigorous PA during sport and leisure time (MVPA-SL) was measured at diagnosis (T0) and 6, 12, 24, and 60 months (T6 to T60) postdiagnosis, using the SQUASH questionnaire. Mixed-effects models were performed to identify sociodemographic and disease-related determinants of MVPA-SL, separately for stage I-III colon (CC), stage I-III rectal cancer (RC), and stage IV CRC (T0 and T6 only). Associations were defined as consistently present when significant at ≥4 timepoints for the stage I-III subsets. MVPA-SL levels were compared with an age- and sex-matched sample of the general Dutch population.

Results: In total, 2905 CC, 1459 RC and 436 stage IV CRC patients were included. Patients with higher fatigue scores, and women compared with men had consistently lower MVPA-SL levels over time, regardless of tumor type and stage. At T6, having a stoma was significantly associated with lower MVPA-SL among stage I-III RC patients. Systemic therapy and radiotherapy were not significantly associated with MVPA-SL changes at T6. Compared with the general population, MVPA-SL levels of CRC patients were lower at all timepoints, most notably at T6.

Conclusions: Female sex and higher fatigue scores were consistent determinants of lower MVPA-SL levels among all CRC patients, and MVPA-SL levels were lowest at 6 months postdiagnosis. Our results can inform the design of intervention studies aimed at improving PA, and guide healthcare professionals in optimizing individualized support.

Trial registration: ClinicalTrials.gov NCT02070146 NCT03191110.

MeSH terms

Cohort Studies
Colorectal Neoplasms* / diagnosis
Exercise
Fatigue
Female
Humans
Male
Quality of Life*

Associated data

ClinicalTrials.gov/NCT02070146
ClinicalTrials.gov/NCT03191110