Abstract 5254: The associations of habitual physical inactivity with cancer outcomes: Evidence from the Roswell Park Cancer Institute Data Bank and BioRepository
Authors: Rikki A. Cannioto, Shruti Dighe, Karen Hulme, Alexandra Drake, Susan E. McCann, Christine B. Ambrosone
Journal: Cancer Research (2018)

Abstract Despite recent position statements asserting that a physically active lifestyle reduces cancer mortality, inverse associations of physical activity (PA) with cancer outcomes are only well established for breast, colorectal, and prostate cancers. Further, the independent associations of physical inactivity with cancer outcomes are rarely reported. Given the prevalence of physical inactivity at the population level and among cancer survivors, we examined the associations of habitual physical inactivity with clinical outcomes in a large patient cohort at Roswell Park Cancer Institute (RPCI). We utilized data from 7,827 patients enrolled in the Data Bank and BioRepository (DBBR) at RPCI between 2003 and 2016. Pre-diagnostic PA, spanning the decade prior to diagnosis, and post-diagnostic PA, representing PA at study enrollment, were assessed by self-administered questionnaire. Patients reporting no regular PA in the decade prior to diagnosis (i.e., walking for exercise, moderate or vigorous PA, or weight training) and no PA after diagnosis were categorized as habitually inactive, our primary analytic exposure of interest. Multivariable Cox proportional hazards models adjusted for age, sex, stage, and tumor site were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) representing associations of habitual inactivity with all-cause mortality, cancer mortality, and disease recurrence. Additional variables (e.g., race, education, smoking, BMI, diabetes, tumor grade, treatment, occupational PA, etc.) were assessed for confounding utilizing the 10% change-in-estimate method. During the follow-up period, median time to follow-up was 54 months and 2,504 (32%) patients died. Collectively, 1,372 patients (17.5%) self-reported habitual inactivity. In comparison to patients who engaged in regular PA before and after diagnosis, habitually inactive patients experienced increased hazards of all-cause mortality (HR=1.41, 95% CI: 1.27-1.56, p&amp;lt;0.001), cancer mortality (HR=1.34, 95% CI: 1.19-1.52, p&amp;lt;0.001) and cancer recurrence (HR=1.15, 95% CI: 1.05-1.26, p=0.004). Associations remained robust and consistent in subgroup analyses by sex, stage and BMI. In sensitivity analyses, associations were strengthened when excluding patients with &amp;lt;3 years of follow-up and remained significant when excluding breast, colorectal and prostate cancer patients for all-cause mortality (HR=1.33, 95% CI: 1.18-1.50, p&amp;lt;0.001), cancer-specific mortality (HR=1.32, 95% CI: 1.14-1.52, p&amp;lt;0.001) and disease recurrence (HR =1.17, 95% CI: 1.04-1.30, p=0.007). We observed consistent evidence that habitual inactivity associates with increased hazards of cancer recurrence and mortality across multiple tumor types. Well-designed survivorship studies are needed to confirm how much mortality can be reduced among regularly active cancer patients. Citation Format: Rikki A. Cannioto, Shruti Dighe, Karen Hulme, Alexandra Drake, Susan E. McCann, Christine B. Ambrosone. The associations of habitual physical inactivity with cancer outcomes: Evidence from the Roswell Park Cancer Institute Data Bank and BioRepository [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5254.