In a Canadian study reported in the Journal of Clinical Oncology, Friedenreich et al found that postdiagnosis recreational physical activity was associated with significantly improved disease-free and overall survival among women with invasive endometrial cancer.
“Recreational physical activity, especially postdiagnosis, is associated with improved survival in survivors of endometrial cancer.”— Friedenreich et al
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Study Details
The prospective cohort study included 425 women in Alberta diagnosed with invasive endometrial cancer between 2002 and 2006 and followed through 2019. Patients completed the Lifetime Total Physical Activity Questionnaire prediagnosis (assessed at a median of 4.4 months after diagnosis) and postdiagnosis (at a median of 3.4 years after diagnosis). Physical activity was measured as metabolic-equivalent task (MET) hours per week per year. Associations between physical activity and overall and disease-free survival were analyzed with adjustment for age, stage, grade, treatments, body mass index, menopausal status, hormone therapy use, family history of cancer, and comorbidities.
Key Findings
After a median follow-up of 14.5 years, there were 60 deaths (including 18 due to endometrial cancer) and 80 disease-free survival events.
For prediagnosis physical activity domains other than recreational activity, a significant association was observed between higher total physical activity and improved overall survival, but no associations with disease-free or overall survival were observed for occupational or household physical activity.
For postdiagnosis physical activity domains other than recreational activity, significant associations were observed between higher total physical activity, higher occupational physical activity, and higher household physical activity and improved disease-free survival.
Higher prediagnosis recreational physical activity was significantly associated with improved disease-free survival (> 14 vs ≤ 8 MET-h/wk/yr; hazard ratio [HR] = 0.54, 95% confidence interval [CI] = 0.30–0.96, P for trend = .04), but not overall survival (HR = 0.56, 95% CI = 0.29–1.07, P for trend = .06).
Higher postdiagnosis recreational physical activity (> 13 vs ≤ 5 MET-h/wk/yr) was strongly associated with both improved disease-free survival (HR = 0.33, 95% CI = 0.17–0.64, P for trend = .001) and overall survival (HR = 0.33, 95% CI = 0.15–0.75, P for trend = .007).
Maintained high recreational physical activity from prediagnosis to postdiagnosis was also strongly associated with improved disease-free survival (HR = 0.35, 95% CI = 0.18–0.69) and overall survival (HR = 0.43, 95% CI = 0.20–0.94) compared with maintained low physical activity.
The investigators concluded, “Recreational physical activity, especially postdiagnosis, is associated with improved survival in survivors of endometrial cancer.”
Christine M. Friedenreich, PhD, of the Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the Canadian Institutes of Health Research and the Alberta Heritage Foundation for Medical Research/Alberta Innovates, U.S. National Cancer Institute, and National Cancer Institute of Canada. For full disclosures of the study authors, visit ascopubs.org.
