Jiang Zhihan, Wang Bingyan, Zhao Yifei, Weng Jing, Liao Jiaojiao, Tao Liyuan, Sun Kui, Zhang Zhipeng, Zhou Xin, Fu Wei
Department of General Surgery, Peking University Third Hospital, Peking University, Beijing 100191, China; Beijing Key Laboratory for Interdisciplinary Research in Gastrointestinal Oncology (BLGO), Beijing 100191, China.
Clinical Epidemiology Research Center, Peking University Third Hospital, Peking University, Beijing 100191, China.
J Nutr Health Aging. 2025 May 26;29(8):100586. doi: 10.1016/j.jnha.2025.100586.
Postdiagnosis physical activity is an important component of healthy lifestyle in cancer survivors. In this study, we aimed to explore the association between intensity and duration of physical activity measured by wearable accelerometers and mortality among pan-cancer survivors.
A prospective cohort study involving cancer survivors (n = 11,708) from UK Biobank was performed. All participants had thorough physical activity data that was measured by wrist-worn accelerometers. Restricted cubic splines and multivariate Cox proportional hazards models were employed to assess the dose-response associations between physical activity time at varying intensities and both all-cause and cancer-specific mortality.
During a median follow-up of 8.9 years, a total of 983 deaths occurred, including 656 cancer-related deaths. Multivariate models identified significant dose-response associations between moderate to vigorous-intensity physical activity (MVPA) time and mortality. Hazard ratios (HRs) for all-cause mortality were 0.64 (95% CI, 0.54-0.76), 0.61 (95% CI, 0.51-0.74) and 0.52 (95% CI, 0.42-0.66) in participants with MVPA time of 272-407, 407-579 and ≥579 min per week, respectively. HRs for cancer-specific mortality were 0.71 (95% CI, 0.58-0.88), 0.69 (95%CI, 0.55-0.87) and 0.61 (95%CI, 0.47-0.81) for the aforementioned groups. Similar patterns were observed for moderate-intensity physical activity but not for light-intensity physical activity. Survival benefits of active physical activity were pronounced in cancers from multiple organs.
Active physical activity substantially reduced all-cause mortality in pan-cancer survivors and cancer-specific mortality in cancer survivors of specific sites. However, the benefits were significant only when intensity of physical activity reached moderate to vigorous level.
诊断后进行体育活动是癌症幸存者健康生活方式的重要组成部分。在本研究中，我们旨在探讨通过可穿戴式加速度计测量的体育活动强度和持续时间与全癌幸存者死亡率之间的关联。
对英国生物银行的癌症幸存者（n = 11708）进行了一项前瞻性队列研究。所有参与者都有通过手腕佩戴的加速度计测量的全面体育活动数据。采用受限立方样条和多变量Cox比例风险模型来评估不同强度体育活动时间与全因死亡率和癌症特异性死亡率之间的剂量反应关联。
在中位随访8.9年期间，共发生983例死亡，其中656例与癌症相关。多变量模型确定了中度至剧烈强度体育活动（MVPA）时间与死亡率之间存在显著的剂量反应关联。每周MVPA时间为272 - 407、407 - 579和≥579分钟的参与者，全因死亡率的风险比（HR）分别为0.64（95%CI，0.54 - 0.76）、0.61（95%CI，0.51 - 0.74）和0.52（95%CI，0.42 - 0.66）。上述组别的癌症特异性死亡率的HR分别为0.71（95%CI，0.58 - 0.88）、0.69（95%CI，0.55 - 0.87）和0.61（95%CI，0.47 - 0.81）。中度强度体育活动也观察到类似模式，但轻度强度体育活动未观察到。积极体育活动对多个器官癌症患者的生存益处显著。
积极体育活动可大幅降低全癌幸存者的全因死亡率以及特定部位癌症幸存者的癌症特异性死亡率。然而，只有当体育活动强度达到中度至剧烈水平时，益处才显著。
