Postdiagnosis sedentary behavior and health outcomes in cancer survivors: A systematic review and meta‐analysis
Authors
Swain, Christopher TVNguyen, Nga H
Eagles, Tobyn
Vallance, Jeff K
Boyle, Terry
Lahart, Ian

Lynch, Brigid M
Issue Date
2019-11-12
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Background High levels of sedentary behavior may negatively affect health outcomes in cancer survivors. A systematic review and meta‐analysis was performed to clarify whether postdiagnosis sedentary behavior is related to survival, patient‐reported outcomes, and anthropometric outcomes in cancer survivors. Methods The Ovid MEDLINE, EMBASE, CINAHL (The Cumulative Index to Nursing and Allied Health Literature), and SPORTDiscus databases were searched from study inception to June 2019. Studies of adults who had been diagnosed with cancer that examined the association between sedentary behavior and mortality, patient‐reported outcomes (eg, fatigue, depression), or anthropometric outcomes (eg, body mass index, waist circumference) were eligible for inclusion. Meta‐analyses were performed to estimate hazard ratios for the highest compared with the lowest levels of sedentary behavior for all‐cause and colorectal cancer‐specific mortality outcomes. The ROBINS‐E (Risk of Bias in Nonrandomized Studies‐of Exposures tool) and the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system were used to assess the risk of bias and the strength of evidence, respectively. Results Thirty‐three eligible publications from a total of 3569 identified articles were included in the review. A higher level of postdiagnosis sedentary behavior was associated with an increased risk of all‐cause mortality (hazard ratio, 1.22; 95% CI, 1.06‐1.41; heterogeneity [I2 statistic], 33.8%) as well as colorectal cancer‐specific mortality (hazard ratio, 1.53; 95% CI, 1.14‐2.06; I2, 0%). No clear or consistent associations between sedentary behavior and patient‐reported or anthropometric outcomes were identified. The risk of bias in individual studies ranged from moderate to serious, and the strength of evidence ranged from very low to low. Conclusions Although avoiding high levels of sedentary behavior after a cancer diagnosis may improve survival, further research is required to help clarify whether the association is causal.Citation
Swain, C. T. V., Nguyen, N. H., eagles, T., Vallance, J. K., Boyle, T. Lahart, I. M and Lynch, B. M. (2019) Postdiagnosis sedentary behavior and health outcomes in cancer survivors: A systematic review and meta‐analysis, Cancer. https://doi.org/10.1002/cncr.32578Publisher
WileyJournal
CancerAdditional Links
https://onlinelibrary.wiley.com/doi/10.1002/cncr.32578Type
Journal articleLanguage
enISSN
0008-543XEISSN
1097-0142Sponsors
Jeff K. Vallance is supported by the Canada Research Chairs program. Brigid Lynch is supported by a fellowship from the Victorian Cancer Agency (MCRF18005).ae974a485f413a2113503eed53cd6c53
10.1002/cncr.32578
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