Originally published as JCO Early Release 10.1200/JCO.2006.06.0855 on July 5 2006

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Meyerhardt, J. A. Articles by Fuchs, C. S. Search for Related Content PubMed PubMed Citation Articles by Meyerhardt, J. A. Articles by Fuchs, C. S. Pubmed/NCBI databases Medline Plus Health Information Colorectal Cancer Exercise for Children Exercise for Seniors Exercise and Physical Fitness Related Articles Related Editorial Social Bookmarking                            What's this?

Physical Activity and Survival After Colorectal Cancer Diagnosis

Jeffrey A. Meyerhardt, Edward L. Giovannucci, Michelle D. Holmes, Andrew T. Chan, Jennifer A. Chan, Graham A. Colditz, Charles S. Fuchs

From the Division of Medical Oncology, Dana-Farber Cancer Institute; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Harvard School of Public Health; Department of Medicine, Massachusetts General Hospital, Boston, MA

Address reprint requests to Jeffrey A. Meyerhardt, MD, MPH, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115; e-mail: jmeyerhardt{at}partners.org

PURPOSE: Physically active individuals have a lower risk of developing colorectal cancer but the influence of exercise on cancer survival is unknown.

PATIENTS AND METHODS: By a prospective, observational study of 573 women with stage I to III colorectal cancer, we studied colorectal cancer–specific and overall mortality according to predefined physical activity categories before and after diagnosis and by change in activity after diagnosis. To minimize bias by occult recurrences, we excluded women who died within 6 months of their postdiagnosis physical activity assessment.

RESULTS: Increasing levels of exercise after diagnosis of nonmetastatic colorectal cancer reduced cancer-specific mortality (P for trend = .008) and overall mortality (P for trend = .003). Compared with women who engaged in less than 3 metabolic equivalent task [MET] -hours per week of physical activity, those engaging in at least 18 MET-hours per week had an adjusted hazard ratio for colorectal cancer–specific mortality of 0.39 (95% CI, 0.18 to 0.82) and an adjusted hazard ratio for overall mortality of 0.43 (95% CI, 0.25 to 0.74). These results remained unchanged even after excluding women who died within 12 and 24 months of activity assessment. Prediagnosis physical activity was not predictive of mortality. Women who increased their activity (when comparing prediagnosis to postdiagnosis values) had a hazard ratio of 0.48 (95% CI, 0.24 to 0.97) for colorectal cancer deaths and a hazard ratio of 0.51 (95% CI, 0.30 to 0.85) for any-cause death, compared with those with no change in activity.

CONCLUSION: Recreational physical activity after the diagnosis of stages I to III colorectal cancer may reduce the risk of colorectal cancer–specific and overall mortality.

Supported in part by a K07 award from the National Cancer Institute (Grant No. K07CA097992-01A1) and an American Society of Clinical Oncology Career Development Award (J.A.M.). The Nurses' Health Study is supported in part by Grant No. P01CA087969 from the National Cancer Institute.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

Related Editorial

• Cancer Survival: Time to Get Moving? Data Accumulate Suggesting a Link Between Physical Activity and Cancer Survival
  Wendy Demark-Wahnefried
  JCO 2006 24: 3517-3518 [Full Text]

This article has been cited by other articles:

				J. A. Meyerhardt, S. Ogino, G. J. Kirkner, A. T. Chan, B. Wolpin, K. Ng, K. Nosho, K. Shima, E. L. Giovannucci, M. Loda, et al. Interaction of Molecular Markers and Physical Activity on Mortality in Patients with Colon Cancer Clin. Cancer Res., September 15, 2009; 15(18): 5931 - 5936. [Abstract] [Full Text] [PDF]

				C. Rabin Promoting Lifestyle Change Among Cancer Survivors: When Is the Teachable Moment? American Journal of Lifestyle Medicine, September 1, 2009; 3(5): 369 - 378. [Abstract] [PDF]

				R. F. Zoeller Jr Lifestyle in the Prevention and Management of Cancer: Physical Activity American Journal of Lifestyle Medicine, September 1, 2009; 3(5): 353 - 361. [Abstract] [PDF]

				A. T. Chan, S. Ogino, and C. S. Fuchs Aspirin Use and Survival After Diagnosis of Colorectal Cancer JAMA, August 12, 2009; 302(6): 649 - 658. [Abstract] [Full Text] [PDF]

				A. I. Neugut Aspirin as Adjuvant Therapy for Colorectal Cancer: A Promising New Twist for an Old Drug JAMA, August 12, 2009; 302(6): 688 - 689. [Full Text] [PDF]

				S. A. Duffy, D. L. Ronis, S. McLean, K. E. Fowler, S. B. Gruber, G. T. Wolf, and J. E. Terrell Pretreatment Health Behaviors Predict Survival Among Patients With Head and Neck Squamous Cell Carcinoma J. Clin. Oncol., April 20, 2009; 27(12): 1969 - 1975. [Abstract] [Full Text] [PDF]

				S. Ogino, K. Nosho, G. J. Kirkner, K. Shima, N. Irahara, S. Kure, A. T. Chan, J. A. Engelman, P. Kraft, L. C. Cantley, et al. PIK3CA Mutation Is Associated With Poor Prognosis Among Patients With Curatively Resected Colon Cancer J. Clin. Oncol., March 20, 2009; 27(9): 1477 - 1484. [Abstract] [Full Text] [PDF]

				K. M. Bellizzi, J. H. Rowland, N. K. Arora, A. S. Hamilton, M. F. Miller, and N. M. Aziz Physical Activity and Quality of Life in Adult Survivors of Non-Hodgkin's Lymphoma J. Clin. Oncol., February 20, 2009; 27(6): 960 - 966. [Abstract] [Full Text] [PDF]

				B. M. Wolpin, J. A. Meyerhardt, A. T. Chan, K. Ng, J. A. Chan, K. Wu, M. N. Pollak, E. L. Giovannucci, and C. S. Fuchs Insulin, the Insulin-Like Growth Factor Axis, and Mortality in Patients With Nonmetastatic Colorectal Cancer J. Clin. Oncol., January 10, 2009; 27(2): 176 - 185. [Abstract] [Full Text] [PDF]

				S. Ogino, K. Nosho, G. J Kirkner, T. Kawasaki, J. A Meyerhardt, M. Loda, E. L Giovannucci, and C. S Fuchs CpG island methylator phenotype, microsatellite instability, BRAF mutation and clinical outcome in colon cancer Gut, January 1, 2009; 58(1): 90 - 96. [Abstract] [Full Text] [PDF]

				M L Irwin Physical activity interventions for cancer survivors Br. J. Sports Med., January 1, 2009; 43(1): 32 - 38. [Abstract] [Full Text] [PDF]

				J. A. Ligibel, W. Demark-Wahnefried, and P. J. Goodwin Diet, Exercise, and Supplements: Guidelines for Cancer Survivors ASCO Educational Book, January 1, 2009; 2009(1): 541 - 547. [Abstract] [Full Text] [PDF]

				S. Ogino, K. Nosho, J. A. Meyerhardt, G. J. Kirkner, A. T. Chan, T. Kawasaki, E. L. Giovannucci, M. Loda, and C. S. Fuchs Cohort Study of Fatty Acid Synthase Expression and Patient Survival in Colon Cancer J. Clin. Oncol., December 10, 2008; 26(35): 5713 - 5720. [Abstract] [Full Text] [PDF]

				C. E. Mosher, I. M. Lipkus, R. Sloane, W. E. Kraus, D. C. Snyder, B. Peterson, L. W. Jones, and W. Demark-Wahnefried Cancer Survivors' Health Worries and Associations with Lifestyle Practices J Health Psychol, November 1, 2008; 13(8): 1105 - 1112. [Abstract] [PDF]

				J. A. Meyerhardt, D. Niedzwiecki, D. Hollis, L. B. Saltz, R. J. Mayer, H. Nelson, R. Whittom, A. Hantel, J. Thomas, and C. S. Fuchs Impact of Body Mass Index and Weight Change After Treatment on Cancer Recurrence and Survival in Patients With Stage III Colon Cancer: Findings From Cancer and Leukemia Group B 89803 J. Clin. Oncol., September 1, 2008; 26(25): 4109 - 4115. [Abstract] [Full Text] [PDF]

				M. L. Irwin, A. W. Smith, A. McTiernan, R. Ballard-Barbash, K. Cronin, F. D. Gilliland, R. N. Baumgartner, K. B. Baumgartner, and L. Bernstein Influence of Pre- and Postdiagnosis Physical Activity on Mortality in Breast Cancer Survivors: The Health, Eating, Activity, and Lifestyle Study J. Clin. Oncol., August 20, 2008; 26(24): 3958 - 3964. [Abstract] [Full Text] [PDF]

				K. Ng, J. A. Meyerhardt, K. Wu, D. Feskanich, B. W. Hollis, E. L. Giovannucci, and C. S. Fuchs Circulating 25-Hydroxyvitamin D Levels and Survival in Patients With Colorectal Cancer J. Clin. Oncol., June 20, 2008; 26(18): 2984 - 2991. [Abstract] [Full Text] [PDF]

				C. M. Blanchard, K. S. Courneya, and K. Stein Cancer Survivors' Adherence to Lifestyle Behavior Recommendations and Associations With Health-Related Quality of Life: Results From the American Cancer Society's SCS-II J. Clin. Oncol., May 1, 2008; 26(13): 2198 - 2204. [Abstract] [Full Text] [PDF]

				K. S Courneya Physical Activity in Cancer Survivors: Possible Associations with Clinical Outcomes Am. Assoc. Cancer Res. Educ. Book, April 12, 2008; 2008(1): 417 - 420. [Abstract] [Full Text] [PDF]

				T. I.L. Nilsen, P. R. Romundstad, H. Petersen, D. Gunnell, and L. J. Vatten Recreational Physical Activity and Cancer Risk in Subsites of the Colon (the Nord-Trondelag Health Study) Cancer Epidemiol. Biomarkers Prev., January 1, 2008; 17(1): 183 - 188. [Abstract] [Full Text] [PDF]

				C. G. Willett, B. G. Czito, and J. C. Bendell Radiation Therapy in Stage II and III Rectal Cancer Clin. Cancer Res., November 15, 2007; 13(22): 6903s - 6908s. [Abstract] [Full Text] [PDF]

				J. A. Meyerhardt, D. Niedzwiecki, D. Hollis, L. B. Saltz, F. B. Hu, R. J. Mayer, H. Nelson, R. Whittom, A. Hantel, J. Thomas, et al. Association of Dietary Patterns With Cancer Recurrence and Survival in Patients With Stage III Colon Cancer JAMA, August 15, 2007; 298(7): 754 - 764. [Abstract] [Full Text] [PDF]

				B. K. Pedersen State of the Art Reviews: Health Benefits Related to Exercise in Patients With Chronic Low-Grade Systemic Inflammation American Journal of Lifestyle Medicine, August 1, 2007; 1(4): 289 - 298. [Abstract] [PDF]

				W. Demark-Wahnefried, E. C. Clipp, I. M. Lipkus, D. Lobach, D. C. Snyder, R. Sloane, B. Peterson, J. M. Macri, C. L. Rock, C. M. McBride, et al. Main Outcomes of the FRESH START Trial: A Sequentially Tailored, Diet and Exercise Mailed Print Intervention Among Breast and Prostate Cancer Survivors J. Clin. Oncol., July 1, 2007; 25(19): 2709 - 2718. [Abstract] [Full Text] [PDF]

				S. Ogino, T. Kawasaki, G. J. Kirkner, P. Kraft, M. Loda, and C. S. Fuchs Evaluation of Markers for CpG Island Methylator Phenotype (CIMP) in Colorectal Cancer by a Large Population-Based Sample J. Mol. Diagn., July 1, 2007; 9(3): 305 - 314. [Abstract] [Full Text] [PDF]

				J. A. Chan, J. A. Meyerhardt, A. T. Chan, E. L. Giovannucci, G. A. Colditz, and C. S. Fuchs Hormone Replacement Therapy and Survival After Colorectal Cancer Diagnosis J. Clin. Oncol., December 20, 2006; 24(36): 5680 - 5686. [Abstract] [Full Text] [PDF]

				C. Doyle, L. H. Kushi, T. Byers, K. S. Courneya, W. Demark-Wahnefried, B. Grant, A. McTiernan, C. L. Rock, C. Thompson, T. Gansler, et al. Nutrition and Physical Activity During and After Cancer Treatment: An American Cancer Society Guide for Informed Choices CA Cancer J Clin, November 1, 2006; 56(6): 323 - 353. [Abstract] [Full Text] [PDF]

				J. A. Meyerhardt, D. Heseltine, D. Niedzwiecki, D. Hollis, L. B. Saltz, R. J. Mayer, J. Thomas, H. Nelson, R. Whittom, A. Hantel, et al. Impact of Physical Activity on Cancer Recurrence and Survival in Patients With Stage III Colon Cancer: Findings From CALGB 89803 J. Clin. Oncol., August 1, 2006; 24(22): 3535 - 3541. [Abstract] [Full Text] [PDF]

				W. Demark-Wahnefried Cancer Survival: Time to Get Moving? Data Accumulate Suggesting a Link Between Physical Activity and Cancer Survival J. Clin. Oncol., August 1, 2006; 24(22): 3517 - 3518. [Full Text] [PDF]