Post-diagnosis exercise and mortality risk in cancer survivors
Principal Investigator
Name
Jessica Gorzelitz
Degrees
Ph.D., M.S.
Institution
University of Iowa
Position Title
Assistant professor
Email
About this CDAS Project
Study
PLCO
(Learn more about this study)
Project ID
PLCO-1032
Initial CDAS Request Approval
Sep 6, 2022
Title
Post-diagnosis exercise and mortality risk in cancer survivors
Summary
The physical activity guidelines recommend muscle strengthening activity (MSA, also known as resistance or strength training) for the whole body on at least 2 days per week [1]. These recommendations are provided to maximize health benefits such as lower risk of chronic diseases and reduced mortality [1]. Most epidemiologic associations of physical activity and cancer incidence have examined aerobic activity, with limited studies examining MSA. In a pooled analysis, moderate to vigorous intensity (aerobic) activity was linked to a lower risk of developing 13 types of cancer, including endometrial cancer [2]. Mazzilli et. al recently published using the AARP cohort data showing MSA was associated with a lower risk of colon cancer, however only ten cancer types were studied, excluding all gynecologic malignancies [3].
Most studies show that aerobic exercise reduces risk of mortality in adults [4]. Those studies isolating MSA as an exposure have found lower risks of mortality in healthy adults [5, 6] and in cancer survivors specifically [7]. However, these associations have not been consistent across studies, as some report no association with MSA [4, 6]. In gynecologic cancer survivors specifically, observational data has been mixed about the impact of self-reported physical activity on mortality [8, 9]. To date, no studies have examined the independent association of MSA on mortality in gynecologic cancer survivors.
The epidemiologic evidence base for weightlifting and cancer is very scant, including very limited evidence on the characteristics of those who participate in weightlifting behaviors. This is even more limited when restricting to adults with a previous cancer diagnosis, known as cancer survivors. Only three publications to date (Bennie 2016, Bennie 2018 and Bennie 2020**) have published on the characteristics of those who report weightlifting from epidemiologic studies, and these publications used population-based studies which were not specific to cancer. Understanding the demographics and characteristics (i.e. age, marital status, education, smoking, health history) of cancer survivors who report weightlifting is a necessary first step in this analysis to represent the causal framework appropriately. Furthermore, once the characteristics have been identified, the influence of weightlifting on mortality risk can be tested. This analysis will be restricted to adults with an incident cancer diagnosis during the PLCO follow up period, using the SQX assessment of weightlifting to link to mortality risk.
This is a modification of PLCO-665 “Characteristics associated with weightlifting, cancer risk and associated mortality” to revise that application to be specific for cancer survivors. Additionally, I have switched institutions outside of DCEG (now at the University of Iowa) and understand I will only have access to the restricted registry version.
Most studies show that aerobic exercise reduces risk of mortality in adults [4]. Those studies isolating MSA as an exposure have found lower risks of mortality in healthy adults [5, 6] and in cancer survivors specifically [7]. However, these associations have not been consistent across studies, as some report no association with MSA [4, 6]. In gynecologic cancer survivors specifically, observational data has been mixed about the impact of self-reported physical activity on mortality [8, 9]. To date, no studies have examined the independent association of MSA on mortality in gynecologic cancer survivors.
The epidemiologic evidence base for weightlifting and cancer is very scant, including very limited evidence on the characteristics of those who participate in weightlifting behaviors. This is even more limited when restricting to adults with a previous cancer diagnosis, known as cancer survivors. Only three publications to date (Bennie 2016, Bennie 2018 and Bennie 2020**) have published on the characteristics of those who report weightlifting from epidemiologic studies, and these publications used population-based studies which were not specific to cancer. Understanding the demographics and characteristics (i.e. age, marital status, education, smoking, health history) of cancer survivors who report weightlifting is a necessary first step in this analysis to represent the causal framework appropriately. Furthermore, once the characteristics have been identified, the influence of weightlifting on mortality risk can be tested. This analysis will be restricted to adults with an incident cancer diagnosis during the PLCO follow up period, using the SQX assessment of weightlifting to link to mortality risk.
This is a modification of PLCO-665 “Characteristics associated with weightlifting, cancer risk and associated mortality” to revise that application to be specific for cancer survivors. Additionally, I have switched institutions outside of DCEG (now at the University of Iowa) and understand I will only have access to the restricted registry version.
Aims
1. Identify and describe the demographic and behavioral characteristics associated with cancer survivors (restricted by primary site) who report weightlifting activity.
2. Determine if weightlifting is associated with reduced mortality (all-cause, cancer-specific and cardiovascular-disease specific); these analyses will be restricted by primary tumor site
Collaborators
Chuck Matthews (DCEG/MEB)