Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany.
Cancer Prev Res (Phila). 2020 Jul;13(7):611-622. doi: 10.1158/1940-6207.CAPR-19-0377. Epub 2020 Apr 6.
Evidence suggests that physical activity (PA) is positively associated with (health-related) quality of life (QOL) in colorectal cancer survivors. However, little is known regarding long-term effects of PA on QOL and if prediagnosis PA is associated with QOL in the years after diagnosis. Our study aimed to investigate the association of prediagnosis and postdiagnosis PA with long-term QOL in colorectal cancer survivors.This study is based on a population-based cohort from Germany of 1,781 newly diagnosed colorectal cancer survivors over a 5-year period. PA was assessed at diagnosis and at 5-year follow-up (5YFU). Quality of life was assessed by the European Organisation for Research and Treatment of Cancer C Quality of Life Questionnaire QLQ-C30 at 5YFU. Multivariable linear regression was used to explore associations between prediagnosis and postdiagnosis PA and QOL at 5YFU.No evidence of a positive association between higher levels of prediagnosis PA and better long-term QOL was found. Higher levels of prediagnosis work-related PA and vigorous PA were even associated with decreased QOL in domains such as cognitive [Beta(β) = -2.52, 95% confidence interval (CI) = -3.77, -1.27; β = -1.92, CI = -3.17, -0.67) and emotional functioning (β = -2.52, CI = -3.84, -1.19; β = -2.12, CI = -3.44, -0.80). In cross-sectional analyses, higher postdiagnosis PA was strongly associated with higher QOL. Survivors physically active at both prediagnosis and postdiagnosis as well as survivors who increased their PA between prediagnosis and postdiagnosis reported significantly higher long-term QOL compared with survivors who remained inactive at prediagnosis and postdiagnosis. In this study, higher prediagnosis PA does not appear to be associated with higher QOL among long-term colorectal cancer survivors but our results support the importance of ongoing PA throughout survivorship.
有证据表明，身体活动（PA）与结直肠癌幸存者的（健康相关）生活质量（QOL）呈正相关。然而，关于 PA 对 QOL 的长期影响以及诊断前的 PA 是否与诊断后几年的 QOL 相关知之甚少。我们的研究旨在调查诊断前和诊断后 PA 与结直肠癌幸存者长期 QOL 的关系。
这项研究基于德国的一个基于人群的队列，该队列包括在 5 年内新诊断出的 1781 名结直肠癌幸存者。PA 在诊断时和 5 年随访（5YFU）时进行评估。5YFU 时，生活质量通过欧洲癌症研究与治疗组织的欧洲癌症研究与治疗组织生活质量问卷 QLQ-C30 进行评估。使用多变量线性回归来探讨诊断前和诊断后 PA 与 5YFU 时 QOL 之间的关联。
没有发现较高水平的诊断前 PA 与更好的长期 QOL 之间存在正相关的证据。较高水平的诊断前工作相关 PA 和剧烈 PA 甚至与认知功能（β= -2.52，95%置信区间（CI）= -3.77，-1.27；β= -1.92，CI = -3.17，-0.67）和情绪功能（β= -2.52，CI = -3.84，-1.19；β= -2.12，CI = -3.44，-0.80）等领域的 QOL 下降相关。在横断面分析中，较高的诊断后 PA 与较高的 QOL 强烈相关。与诊断前和诊断后均不活跃的幸存者相比，诊断前和诊断后增加 PA 的幸存者报告的长期 QOL 明显更高。在这项研究中，较高的诊断前 PA 似乎与长期结直肠癌幸存者的较高 QOL 无关，但我们的结果支持在整个生存期间持续进行 PA 的重要性。
