Association of Physical Activity Intensity with All-Cause Mortality in Cancer Survivors: A National Prospective Cohort Study

Abstract

We designed this study to investigate the associations between physical activity (PA) and the risk of all-cause mortality in cancer survivors using a nationally representative cohort of US adults. This cohort study included 13 cycles of the National Health Interview Surveys, and by matching participants with the National Death Index (2015), survival status was determined. The main outcome was all-cause mortality during follow-up. A total of 20,088 participants aged 62.2 (15.9) years (62.4% women) were analyzed. After an average follow-up of 117.5 months, 7214 (35.9%) participants died. Compared with inactive cancer survivors, we observed a 25% lower all-cause mortality risk among participants performing PA 10 min to 1 h/week (hazard ratio [HR] = 0.75, 95% confidence interval [CI] = 0.67–0.85), a 28% lower risk among those performing PA 1–2.5 h/week (HR = 0.72, 95% CI = 0.67–0.78), a 34% lower risk among those performing PA 2.5–5 h/week (HR = 0.66, 95% CI = 0.60–0.72), a 37% lower risk among those performing PA 5–7.5 h/week (HR = 0.63, 95% CI = 0.56–0.70), a 47% lower risk among those performing PA 7.5–13.3 h/week (HR = 0.53, 95% CI = 0.47–0.61), and a 43% lower risk among those performing PA 13.3–24 h/week (adjusted HR = 0.53, 95% CI = 0.49–0.66). In cancer survivors, leisure-time PA was associated with a lower all-cause mortality. Inactive cancer survivors should be encouraged to perform more PA to reduce the risk of all-cause mortality.