Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
Medical Faculty Heidelberg, University of Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany.
J Cancer Surviv. 2018 Oct;12(5):679-690. doi: 10.1007/s11764-018-0705-9. Epub 2018 Aug 10.
Since physical activity (PA) has been shown to be associated with better prognosis and quality of life (QOL) in colorectal cancer (CRC) patients, this study focuses on the barriers of PA among CRC survivors.
This study is based on a population-based study from Germany of 1343 women and men, diagnosed with CRC between 2003 and 2008 and being alive five years later. Multivariable logistic regression was used to explore associations between baseline as well as five-year follow-up (5YFU) characteristics and physical inactivity (PIA) at 5YFU. Quartiles were calculated based on metabolic equivalent hours per week of PA at baseline and at 5YFU. Participants in quartile 1 were defined as physically inactive, and patients in quartile 2 to quartile 4 were defined as physically active.
Cancer-specific factors such as having a stoma (odds ratio (OR) = 1.51, 95% confidence interval (CI) = 1.12-2.04), demographic factors such as living in a small town or city (OR = 1.46, 95% CI = 1.05-2.02; OR = 1.42, 95% CI = 1.01-2.02), older age (OR = 1.44, 95% CI = 0.80-2.58), or being divorced (OR = 1.72, 95% CI = 0.96-3.07), as well as lifestyle factors such as being a current smoker (OR = 1.54, 95% CI = 1.04-2.29) or being obese (OR = 1.43, 95% CI = 0.96-2.13) were associated with PIA at 5YFU. Subgroup analyses showed that the association between body mass index and PIA was stronger in women than in men. Baseline PA was identified as a strong predictor of PIA at 5YFU.
Findings suggest that predominately patients with a stoma, patients living in a more populated area, being older, divorced, a current smoker, or obese were more likely to be physically inactive and therefore could be targeted to be more physically active.
Addressing barriers for PA might help to develop specific, individually tailored PA interventions to overcome PIA and improve the long-term outcome of CRC survivors.
由于体力活动(PA)已被证明与结直肠癌(CRC)患者的更好预后和生活质量(QOL)相关,因此本研究侧重于CRC 幸存者的 PA 障碍。
本研究基于德国一项基于人群的研究,该研究纳入了 1343 名女性和男性,他们在 2003 年至 2008 年间被诊断患有 CRC,并且在五年后仍存活。多变量逻辑回归用于探讨基线和五年随访(5YFU)特征与 5YFU 时体力不活动(PIA)之间的关系。根据基线和 5YFU 时的 PA 代谢当量小时/周计算四分位数。将第 1 四分位数的患者定义为体力不活跃,第 2 至第 4 四分位数的患者定义为体力活跃。
癌症特异性因素,如存在造口(比值比(OR)=1.51,95%置信区间(CI)=1.12-2.04),人口统计学因素,如居住在小镇或城市(OR=1.46,95%CI=1.05-2.02;OR=1.42,95%CI=1.01-2.02),年龄较大(OR=1.44,95%CI=0.80-2.58),或离异(OR=1.72,95%CI=0.96-3.07),以及生活方式因素,如当前吸烟(OR=1.54,95%CI=1.04-2.29)或肥胖(OR=1.43,95%CI=0.96-2.13),与 5YFU 时的 PIA 相关。亚组分析表明,BMI 与 PIA 的关联在女性中强于男性。基线 PA 是 5YFU 时 PIA 的强预测因素。
研究结果表明,主要有造口的患者、居住在人口较多地区的患者、年龄较大、离异、当前吸烟者或肥胖者更有可能不活跃,因此可以针对这些患者开展更有针对性的、个体化的 PA 干预,以克服 PIA,改善 CRC 幸存者的长期预后。
解决 PA 的障碍可能有助于制定特定的、个体化的 PA 干预措施,以克服 PIA,改善 CRC 幸存者的长期预后。