Survivors of childhood cancer are less active than their peers

1. In a cross-sectional study, adolescent survivors of childhood cancers were more sedentary than age-matched controls.

2. Age, gender, BMI, cancer relapse, and central nervous system tumors were all associated with less physical activity and more sedentary time.

Evidence rating: 2 (Good)

Study Rundown: Childhood cancer survivors are at increased risk for chronic medical conditions such as cardiovascular disease and diabetes mellitus.  Higher levels of physical activity are associated with a variety of long-term health benefits and an improved quality of life in the general population. While children have markedly decreased levels of physical activity during cancer treatment, long-term physical activity levels have not been well-studied. This international, multi-center, cross-sectional study of over 400 childhood cancer survivors aged 9 to 16 years utilized wearable accelerometers to quantify physical activity and sedentary time compared to healthy control reference values. Older age, female sex, survivor of central nervous system (CNS) tumor, previous cancer relapse, and higher body mass index (BMI) were all associated with decreased activity level and more sedentary time compared to the reference population. One important limitation of the study is that the dosage, intensity, and specific chemotherapy data were not available for inclusion in the analysis. Additionally, accelerometers are not able to detect some forms of physical activity, such as swimming, cycling, and resistance training. Overall, this well-designed large multi-center study of childhood cancer survivors supports the need for future interventions to improve physical activity and decrease sedentary time in this vulnerable patient population.

Click to read the study in Pediatrics.

Relevant Reading: Effect of physical activity on fatigue in childhood cancer survivors: a systematic review

In-Depth [cross-sectional study]: This study was a cross-sectional sub-study of the Physical Activity in Childhood Cancer Survivor (PACCs) study. Participants aged 9 to 16 were recruited at scheduled follow up visits from 2017 through 2020. Of 726 participants invited to participate, 432 were ultimately included in the analysis. The mean age at recruitment was 12.2 years and the population was balanced in gender distribution. Descriptive patient data were extracted from participant records. Physical activity data and sedentary time were collected as continuous variables from provided accelerometers. Results were expressed as marginal means in counts per minute (cpm) for total physical activity and total minutes per day for moderate-to-vigorous physical activity (MVPA) and sedentary time (ST). In the participants analyzed, the marginal mean of physical activity was 486 cpm. The marginal mean for MVPA and ST were 54 minutes and 523 minutes per day, respectively. Age was directly correlated with less activity and more sedentary time. Survivors of CNS tumors had the lowest total levels of physical activity and most sedentary time. This group also had the lowest percentage (17%) of participants meeting recommended daily activity levels. Compared with reference populations, male survivors were less active with the most notable differences observed in the 8-9-year-old group (PA 523 vs 633 cpm, P = .003, MVPA 42 vs 61 min, P < .001).

Image: PD

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