Physical Activity and Mortality in Cancer Survivors: A Systematic Review and Meta-Analysis
Open accessAbstract
Background: Recommendations for improved survival after cancer through physical activity (PA) exist, although the evidence is still emerging. Our primary objective was to conduct a systematic review and meta-analysis of the association between prediagnosis and postdiagnosis PA and survival (cancer-specific, all-cause, and cardiovascular disease mortality) for all cancers and by tumor site. Secondary objectives were to examine the associations within population subgroups, by PA domain, and to determine the optimal dose of PA related to survival. Methods: PubMed, EMBASE, and SportsDiscus databases were searched from inception to November 1, 2018. DerSimonian-Laird random-effects models were used to estimate the summary hazard ratios (HRs) and 95% confidence intervals (CI) for primary and secondary analyses and to conduct dose-response analyses. Results: Evidence from 136 studies showed improved survival outcomes with highest vs lowest levels of prediagnosis or postdiagnosis total or recreational PA for all-cancers combined (cancer specific mortality: HR = 0.82, 95% CI = 0.79 to 0.86, and HR = 0.63, 95% CI = 0.53 to 0.75, respectively) as well as for 11 specific cancer sites. For breast and colorectal cancers, greater reductions were observed for postdiagnosis PA (HR = 0.58–0.63) compared with prediagnosis PA (HR = 0.80–0.86) for cancer-specific and all-cause mortality. Survival benefits through PA were observed in most subgroups (within sex, body mass index, menopausal status, colorectal subtypes, and PA domain) examined. Inverse dose-response relationships between PA and breast cancer-specific and all-cause mortality were observed, with steep reductions in hazards to 10–15 metabolic equivalent hours per week. Conclusion: Higher prediagnosis and postdiagnosis levels of PA were associated with improved survival outcomes for at least 11 cancer types, providing support for global promotion of PA guidelines following cancer.
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Scientific evidence supports the safety and effectiveness of physical activity for people with cancer, indicating health benefits such as reduced anxiety, reduced depressive symptoms, reduced fatigue, improved quality of life, and improved physical function.
“Scientific evidence supports the safety and effectiveness of physical activity, indicating—for people with cancer experience—health benefits such as reduced anxiety, reduced depressive symptoms, reduced fatigue, improved quality of life, and improved physical function [40,41,42,43].”
From The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic (2023) · cites this paper as [41]
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIn cancer survivors, high versus low physical activity before diagnosis is associated with improved overall survival (HR 0.82, 95% CI 0.79-0.86).
“High vs. low physical activity prediagnosis (hazard ratio 0.82; 95% confidence interval 0.79–0.86)”
From Physical activity for cancer patients during COVID-19 pandemic: A call to action (2021) · cites this paper as [8]
In cancer survivors, high versus low physical activity after diagnosis is associated with improved overall survival (HR 0.63, 95% CI 0.53-0.75).
“postdiagnosis (hazard ratio 0.63; 95% confidence interval 0.53–0.75) were associated with improved survival outcome for all-cancer combined [8].”
From Physical activity for cancer patients during COVID-19 pandemic: A call to action (2021) · cites this paper as [8]
Prediagnosis and postdiagnosis physical activity are associated with lower cancer-specific and all-cause mortality in breast and colorectal cancer survivors.
“Reductions in cancer-specific mortality and all-cause mortality were also observed for prediagnosis and postdiagnosis physical activity in breast and colorectal cancer survivors [8].”
From Physical activity for cancer patients during COVID-19 pandemic: A call to action (2021) · cites this paper as [8]
Scientific evidence is unclear about the best type or domain of physical activity for people with cancer.
“Of note, scientific evidence is not clear about the best type or domain of physical activity for people with cancer [8]; thus, guidelines suggest to include physical activity as part of everyday life [6].”
From Physical activity for cancer patients during COVID-19 pandemic: A call to action (2021) · cites this paper as [8]
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- Authors
- Friedenreich, C. M., Stone, C. R., Cheung, W. Y., & Hayes, S. C.
- Affiliations
- Alberta Health Services (CA)
- Queensland University of Technology (AU)
- Corresponding author
- Friedenreich, Christine M
- Venue
- JNCI Cancer Spectrum
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-10-17
- Volume
- 4
- Issue
- 1
- Pages
- pkz080-pkz080
- ISSN
- 2515-5091 (ISSN-L)
- PMC
- PMC7050161
- OpenAlex
- W2979390533
- Cited by
- 453
- References
- 165
- Citations by year
- 2026: 62 · 2025: 92 · 2024: 74 · 2023: 82 · 2022: 72 · 2021: 46 · 2020: 23 · 2018: 1
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- JNCI Cancer Spectrum (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by-nc)
- Griffith Research Online (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- physical activity, cancer survivors, cancer-specific mortality, all-cause mortality, cardiovascular mortality, breast cancer, colorectal cancer, dose-response relationship, metabolic equivalent hours
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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