Prospective cohort study of pre- and post-diagnosis physical activity and Endometrial Cancer survival
Oral Presentation C10.1
DOI:
https://doi.org/10.14288/hfjc.v14i3.702Keywords:
Endometrial Cancer, Survival, Mortality, Physical Activity, Cohort StudyAbstract
Background: Physical activity (PA) improves survival outcomes for several cancer sites, but few studies have examined the relationship with endometrial cancer (EC). Purpose: To evaluate associations between overall and disease-free survival with pre- and post-diagnosis PA by domain, intensity and dose (metabolic-equivalent task [MET]-hours/week/year). Methods: A prospective cohort study was conducted in Alberta of 425 women diagnosed with histologically-confirmed invasive EC between 2002-6 and followed to 2019. The interviewer-administered Lifetime Total Physical Activity Questionnaire recorded pre-diagnosis and post-diagnosis PA (~3.5 years after diagnosis). The association between PA and overall and disease-free survival was assessed with Cox-proportional hazard models adjusted for age, stage, grade, treatments, body mass index, menopausal status, hormone therapy use, family history, co-morbidities. Results: Median follow-up time was 14.5 years, during which 60 overall deaths and 80 EC recurrences/progressions or deaths occurred. Greater pre-diagnosis recreational PA was associated with improved disease-free survival (>14 vs ≤8 MET-hours/week/year; HR=0.54; 95% CI: 0.30-0.96; Ptrend=0.04) and overall survival (HR=0.56; 95% CI: 0.29-1.07; Ptrend=0.06). Post-diagnosis recreational PA was strongly associated with improved disease-free and overall survival (>13 vs ≤5 MET-hours/week/year; HR = 0.33, 95% CI: 0.17-0.64, Ptrend=0.001; HR = 0.33, 95% CI: 0.15-0.75, Ptrend=0.007). When participants maintained their recreational PA at the highest levels from pre- to post-diagnosis, they had high overall (HR = 0.43, 95% CI: 0.20-0.94) and disease-free survival (HR = 0.35, 95% CI: 0.18-0.69). Conclusions: Recreational PA may help to improve survival outcomes in EC survivors. Funding: Canadian Cancer Society Grants.
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Copyright (c) 2021 Christine M. Friedenreich, Linda S. Cook, Qinggang Wang, Renee Kokts-Porietis, Jessica McNeil, Charlotte Ryder-Burbidge, Kerry S. Courneya
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