Development of a Risk‐Screening Tool for Cancer Survivors to Participate in Unsupervised Moderate‐ to Vigorous‐Intensity Exercise: Results From a Survey Study
Open accessAbstract
Background: The health benefits of exercise increase in dose‐response fashion among cancer survivors. However, it is unclear how to identify cancer survivors who may require a pre‐exercise evaluation before they progress from the common recommendation of walking to unsupervised moderate‐ to vigorous‐intensity exercise. Objective: To clarify how to identify cancer survivors who should undergo a pre‐exercise evaluation before they progress from the common recommendation of walking to unsupervised moderate‐ to vigorous‐intensity exercise. Design: Electronic survey. Participants: Forty‐seven (n = 47) experts in the field of exercise physiology, rehabilitation medicine, and cancer survivorship. Setting: Not applicable. Methods: We synthesized peer‐reviewed guidelines for exercise and cancer survivorship and identified 82 health factors that may warrant a pre‐exercise evaluation before a survivor engages in unsupervised moderate‐ to vigorous‐intensity exercise. The 82 health factors were classified into 3 domains: (1) clinical health factors; (2) comorbidity and device health factors; and (3) medications. We surveyed a sample of experts asking them to identify which of the 82 health factors among cancer survivors would indicate the need for a pre‐exercise evaluation before they engaged in moderate‐ to vigorous‐intensity exercise. Main Outcome Measurements: The response rate to our survey was 75% (n = 47). Across the 3 domains of health factors, acute symptoms, comorbidities, and medications related to cardiovascular disease were agreed on to indicate a pre‐exercise evaluation for survivors before they engaged in unsupervised moderate‐ to vigorous‐intensity exercise. Other health factors in the survey included hematologic, musculoskeletal, systemic, gastrointestinal, pulmonary, and neurological symptoms and comorbidities. Eighteen experts (38%) said it was difficult to provide absolute answers because no 2 patients are alike, and their decisions are made on a case‐by‐case basis. Conclusions: The results from this expert survey will help to identify which cancer survivors should undergo a pre‐exercise evaluation before they engage in unsupervised moderate‐ to vigorous‐intensity exercise.
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Breast cancer survivors' need for a supervised exercise program at 6 months after active cancer therapy is 35%.
“The proportion of endometrial, colorectal, head and neck, and breast cancer survivors who would need a supervised program were 80%, 58%, 60%, and 35%, respectively.53,70-73”
From Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer (2019) · cites this paper as [70]
Older age at diagnosis predicted the need for exercise supervision in survivors across all four tumor sites.
“Older age at diagnosis predicted the need for exercise supervision in survivors who had all 4 tumor sites.”
From Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer (2019) · cites this paper as [70]
Endometrial cancer survivors' need for a supervised exercise program at 6 months after active cancer therapy is 80%.
“The proportion of endometrial, colorectal, head and neck, and breast cancer survivors who would need a supervised program were 80%, 58%, 60%, and 35%, respectively.53,70-73”
From Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer (2019) · cites this paper as [70]
Head and neck cancer survivors' need for a supervised exercise program at 6 months after active cancer therapy is 60%.
“The proportion of endometrial, colorectal, head and neck, and breast cancer survivors who would need a supervised program were 80%, 58%, 60%, and 35%, respectively.53,70-73”
From Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer (2019) · cites this paper as [70]
Colorectal cancer survivors' need for a supervised exercise program at 6 months after active cancer therapy is 58%.
“The proportion of endometrial, colorectal, head and neck, and breast cancer survivors who would need a supervised program were 80%, 58%, 60%, and 35%, respectively.53,70-73”
From Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer (2019) · cites this paper as [70]
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- Authors
- Brown, J. C., Ko, E. M., & Schmitz, K. H.
- Affiliations
- University of Pennsylvania (US)
- Venue
- PM&R
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- Wiley
- Published
- 2014-09-10
- Volume
- 7
- Issue
- 2
- Pages
- 113-122
- ISSN
- 1934-1482 (ISSN-L)
- 1934-1563
- PMC
- PMC4391374
- OpenAlex
- W2058859067
- Cited by
- 16
- References
- 70
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- FWCI
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- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- PM&R (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (7u54ca155850-06)
- National Cancer Institute (F31CA192560, U54-CA155850, R21CA182767)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- cancer survivors, moderate-to-vigorous intensity exercise, unsupervised exercise, risk screening tool, exercise safety, comorbidities, cardiovascular disease, medication, acute symptoms, expert consensus, exercise recommendations
- MeSH terms
- Health Status, Humans, Mass Screening, Neoplasms, Physical Examination, Surveys and Questionnaires, Risk Factors, Exercise, Risk Assessment, Patient Selection
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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