Determinants of Physical Activity among Patients with Colorectal Cancer: From Diagnosis to 5 Years after Diagnosis. (2024)

Affiliation

• Smit KC; Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS.
• Derksen JWG; Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS.
• Stellato RK; Department of Data Science and Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS.
• VAN Lanen AS; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS.
• Wesselink E; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS.
• Belt EJT; Department of Surgery, Albert Schweitzer Hospital, Dordrecht, THE NETHERLANDS.
• Balen MC; Department of Medical Oncology, Groene Hart Hospital, Gouda, THE NETHERLANDS.
• Coene PPLO; Department of Surgery, Maasstad Hospital, Rotterdam, THE NETHERLANDS.
• Dekker JWT; Department of Surgery, Reinier de Graaf Hospital, Delft, THE NETHERLANDS.
• DE Groot JW; Department of Medical Oncology, Isala Hospital, Zwolle, THE NETHERLANDS.
• Haringhuizen AW; Department of Medical Oncology, Ziekenhuis Gelderse Vallei, Ede, THE NETHERLANDS.
• VAN Halteren HK; Department of Medical Oncology, Admiraal de Ruyter Hospital, Goes, THE NETHERLANDS.
• VAN Heek TT; Department of Surgery, Ziekenhuis Gelderse Vallei, Ede, THE NETHERLANDS.
• Helgason HH; Department of Medical Oncology, Haaglanden Medical Center, Den Haag, THE NETHERLANDS.
• Hendriks MP; Department of Medical Oncology, Northwest Clinics, Alkmaar, THE NETHERLANDS.
• DE Hingh IHJT; Department of Surgery, Catharina Hospital, Eindhoven, THE NETHERLANDS.
• Hoekstra R; Department of Medical Oncology, Ziekenhuisgroep Twente, Hengelo, THE NETHERLANDS.
• Houtsma D; Department of Medical Oncology, Haga Hospital, Den Haag, THE NETHERLANDS.
• Janssen JJB; Department of Medical Oncology, Canisius Wilhelmina Hospital, Nijmegen, THE NETHERLANDS.
• Kok N; Department of Gastrointestinal Oncology, Antoni Van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS.
• Konsten JLM; Department of Surgery, Viecuri Hospital, Venlo, THE NETHERLANDS.
• Los M; Department of Medical Oncology, St. Antonius Hospital, Nieuwegein, THE NETHERLANDS.
• Meijerink MR; Department of Radiology and Nuclear Medicine, VU Medical Center, Amsterdam, THE NETHERLANDS.
• Mekenkamp LJM; Department of Medical Oncology, Medisch Spectrum Twente, Enschede, THE NETHERLANDS.
• Peeters KCMJ; Department of Surgery, Leiden University Medical Center, University of Leiden, Leiden, THE NETHERLANDS.
• Polée MB; Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, THE NETHERLANDS.
• Rietbroek RC; Department of Medical Oncology, Rode Kruis Hospital, Beverwijk, THE NETHERLANDS.
• Schiphorst AHW; Department of Surgery, Diakonessenhuis Hospital, Utrecht, THE NETHERLANDS.
• Schrauwen RWM; Department of Gastroenterology and Hepatology, Bernhoven Hospital, Uden, THE NETHERLANDS.
• Schreinemakers J; Department of Surgery, Amphia Hospital, Breda, THE NETHERLANDS.
• Sie MPS; Department of Medical Oncology, ZorgSaam Hospital, Terneuzen, THE NETHERLANDS.
• Simkens L; Department of Medical Oncology, Maxima Medical Center, Eindhoven, THE NETHERLANDS.
• Sonneveld EJA; Department of Surgery, Dijklander Hospital, Hoorn, THE NETHERLANDS.
• Terheggen F; Department of Medical Oncology, Bravis Hospital, Roosendaal, THE NETHERLANDS.
• Iersel LV; Maastricht University Medical Center, Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University, Maastricht, THE NETHERLANDS.
• Vles WJ; Department of Surgery, Ikazia Hospital, Rotterdam, THE NETHERLANDS.
• Wasowicz-Kemps DK; Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, THE NETHERLANDS.
• DE Wilt JHW; Department of Surgery, Radboud University Medical Center, University of Nijmegen, Nijmegen, THE NETHERLANDS.
• Kok DE; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS.
• Winkels RM; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS.
• Kampman E; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS.
• VAN Duijnhoven FJB; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS.
• Koopman M; Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS.
• May AM; Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS.

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.