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Recreational physical activity, body mass index, and survival in women with colorectal cancer

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Abstract

Background and purpose

Previous studies have shown that physical inactivity and obesity are risk factors for the development of colorectal cancer. However, controversy exists regarding the influence of these factors on survival in colorectal cancer patients. We evaluated the impact of recreational physical activity and body mass index (BMI) before and after colorectal cancer diagnosis on disease-specific mortality and all-cause mortality.

Patients and methods

This prospective cohort study included 1,339 women enrolled in the Women’s Health Initiative study who were diagnosed with colorectal cancer subsequent to study enrollment. BMI and recreational physical activity were measured before cancer diagnosis at study entry (pre-diagnostic) and after diagnosis at study follow-up interviews (post-diagnostic). We used Cox regression to estimate the association between pre- and post-diagnostic exposures and survival after colorectal cancer diagnosis.

Results

Among women diagnosed with colorectal cancer, 265 (13 %) deaths occurred during a median study follow-up of 11.9 years, of which 171 (65 %) were attributed to colorectal cancer. Compared with women reporting no pre-diagnostic recreational physical activity, those reporting activity levels of ≥18 MET-h/week had significantly lower colorectal cancer-specific mortality (hazard ratio (HR) = 0.68; 95 % confidence interval (CI): 0.41–1.13) and all-cause mortality (HR = 0.63; 95 % CI: 0.42–0.96). Similar inverse associations were seen for post-diagnostic recreational physical activity. Neither pre- nor post-diagnostic BMI were associated with mortality after colorectal cancer diagnosis.

Conclusion

Recreational physical activity before and after colorectal cancer diagnosis, but not BMI, is associated with more favorable survival.

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Acknowledgments

This work was supported by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services (contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42107-26, 42129-32, and 44221). This publication was also supported by the National Cancer Institute (R25-CA94880 and K05152715).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Human Nutrition, Wageningen University, Bomenweg 4, 6703 HD, Wageningen, The Netherlands

    Josephina G. Kuiper & Ellen Kampman

  2. Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M4-B402, P.O. Box 19024, Seattle, WA, 98109, USA

    Amanda I. Phipps, Marian L. Neuhouser & Polly A. Newcomb

  3. Los Angeles Biomedical Research Institute Harbor-UCLA Medical Center, 1124 West Carson St, Torrance, CA, 90502, USA

    Rowan T. Chlebowski

  4. Department of Nutritional Sciences, University of Arizona, PO Box 210458, 1145 S Warren, Tucson, AZ, 85721, USA

    Cynthia A. Thomson

  5. Yale School of Public Health, Yale University, 60 College Street, P.O. Box 208034, New Haven, CT, 06520-8034, USA

    Melinda L. Irwin

  6. Community and Behavioral Health Faculty, Stony Brook University Medical Center, 101 Nicolls Road, Stony Brook, NY, 11794, USA

    Dorothy S. Lane

  7. Department of Social and Preventive Medicine, University at Buffalo, 270 Farber Hall, Buffalo, NY, 14214, USA

    Jean Wactawski-Wende

  8. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL, 6061, USA

    Lifang Hou

  9. Division of Endocrinology, Diabetes and Metabolism, Ohio State University, 491 McCampbell Hall 1581 Dodd Drive, Columbus, OH, 43210, USA

    Rebecca D. Jackson

  10. Department of Health Sciences, VU Amsterdam, De Boelelaan 1105, 1081 HV, Amsterdam, The Netherlands

    Ellen Kampman

Authors
  1. Josephina G. Kuiper
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  2. Amanda I. Phipps
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  3. Marian L. Neuhouser
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  6. Melinda L. Irwin
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  7. Dorothy S. Lane
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  8. Jean Wactawski-Wende
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  9. Lifang Hou
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  11. Ellen Kampman
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  12. Polly A. Newcomb
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Corresponding author

Correspondence to Amanda I. Phipps.

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Kuiper, J.G., Phipps, A.I., Neuhouser, M.L. et al. Recreational physical activity, body mass index, and survival in women with colorectal cancer. Cancer Causes Control 23, 1939–1948 (2012). https://doi.org/10.1007/s10552-012-0071-2

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  • DOI: https://doi.org/10.1007/s10552-012-0071-2

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