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    Postdiagnosis sedentary behavior and health outcomes in cancer survivors: A systematic review and meta‐analysis

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    2020-11-12
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    Authors
    Swain, Christopher TV
    Nguyen, Nga H
    Eagles, Tobyn
    Vallance, Jeff K
    Boyle, Terry
    Lahart, Ian M
    Lynch, Brigid M
    Issue Date
    2019-11-12
    
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    Abstract
    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.32578
    Publisher
    Wiley
    Journal
    Cancer
    URI
    http://hdl.handle.net/2436/622937
    DOI
    10.1002/cncr.32578
    Additional Links
    https://onlinelibrary.wiley.com/doi/10.1002/cncr.32578
    Type
    Journal article
    Language
    en
    ISSN
    0008-543X
    EISSN
    1097-0142
    Sponsors
    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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