Bos Mylena D, Sidorenkov Grigory, Vinke Petra C, Ho Cassandra S L, Meyer N Helge, Bockhorn Maximilian, de Groot Derk Jan A, Klaase Joost M, Hoogwater Frederik J H, de Bock Geertruida H, Nijkamp Maarten W
Division of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Cancer Epidemiol Biomarkers Prev. 2025 Sep 2;34(9):1544-1550. doi: 10.1158/1055-9965.EPI-25-0608.
Although higher pre-diagnosis physical activity is linked to lower mortality among cancer survivors, it is unclear whether this is due to a reduced likelihood of metastatic cancer at diagnosis. This study evaluated whether adherence to physical activity guidelines before diagnosis is associated with all-cause mortality and metastatic cancer at diagnosis.
In the prospective Lifelines Cohort Study of 152,915 adults, we identified individuals diagnosed with primary cancer at any site through linkage to the Netherlands Cancer Registry. Adherence to physical activity guidelines was defined as ≥150 minutes of moderate-intensity activity, ≥75 minutes of vigorous-intensity activity, or an equivalent combination per week. Cox and logistic regression estimated adjusted HRs and ORs with 95% confidence intervals (CI) for associations between adherence to physical activity guidelines, all-cause mortality, and metastatic cancer at diagnosis.
A total of 5,990 patients with cancer were included: 10.7% reported no physical activity, 19.1% were insufficiently active, and 70.2% were sufficiently active. Patients with cancer adhering to physical activity guidelines had a 16% lower risk of all-cause mortality compared with those who reported no physical activity (HR = 0.84; 95% CI, 0.72-0.98). However, meeting physical activity guidelines was not significantly associated with a reduced likelihood of metastatic cancer at diagnosis (OR = 0.98; 95% CI, 0.79-1.23).
Physical activity at recommended levels before cancer diagnosis is linked to reduced mortality among cancer survivors, independent of metastatic cancer at diagnosis.
These findings highlight the beneficial role of physical activity in reducing mortality in patients with cancer.
虽然癌症幸存者在诊断前较高的身体活动水平与较低的死亡率相关，但尚不清楚这是否是由于诊断时转移性癌症的可能性降低。本研究评估了诊断前遵守身体活动指南是否与全因死亡率和诊断时的转移性癌症相关。
在对152,915名成年人进行的前瞻性生命线队列研究中，我们通过与荷兰癌症登记处的链接，确定了在任何部位被诊断患有原发性癌症的个体。遵守身体活动指南的定义为每周进行≥150分钟的中等强度活动、≥75分钟的高强度活动或同等组合。Cox回归和逻辑回归估计了遵守身体活动指南、全因死亡率和诊断时转移性癌症之间关联的调整后风险比（HR）和比值比（OR）以及95%置信区间（CI）。
共纳入5990名癌症患者：10.7%报告无身体活动，19.1%身体活动不足，70.2%身体活动充足。与报告无身体活动的患者相比，遵守身体活动指南的癌症患者全因死亡率风险降低16%（HR = 0.84；95% CI，0.72 - 0.98）。然而，达到身体活动指南与诊断时转移性癌症可能性降低无显著关联（OR = 0.98；95% CI，0.79 - 1.23）。
癌症诊断前达到推荐水平的身体活动与癌症幸存者死亡率降低相关，与诊断时的转移性癌症无关。
这些发现凸显了身体活动在降低癌症患者死亡率方面的有益作用。
