Higher levels of leisure-time moderate to vigorous physical activity after a cancer diagnosis were associated with lower risk of cancer mortality among survivors of bladder, endometrial, lung, oral, and rectal cancers not commonly studied for this association.
Key Findings
Results
Low amounts of post-diagnosis MVPA were associated with lower cancer mortality risk among bladder, endometrial, and lung cancer survivors.
Engagement in >0 to <7.5 MET-h/wk vs 0 MET-h/wk was the comparison used for 'low amounts' of MVPA.
Bladder cancer survivors: HR, 0.67 (95% CI, 0.50-0.91).
Endometrial cancer survivors: HR, 0.62 (95% CI, 0.45-0.87).
Lung cancer survivors: HR, 0.56 (95% CI, 0.43-0.75).
Physical activity was assessed a mean (SD) of 2.8 (1.5) years after cancer diagnosis.
Results
Doubling or more the recommended MVPA guideline was associated with lower cancer mortality risk among oral and rectal cancer survivors.
Oral cancer survivors: HR, 0.39 (95% CI, 0.15-0.99) for >22.5 to 30.0 MET-h/wk vs 0 MET-h/wk.
Rectal cancer survivors: HR, 0.57 (95% CI, 0.33-0.97) for >15.0 to 22.5 MET-h/wk vs 0 MET-h/wk.
The threshold for 'doubling the recommended MVPA guideline' was defined as >15 vs 0 MET-h/wk.
These cancers are among those 'not commonly studied' for the association between physical activity and survival.
Results
Point estimates suggested lower cancer mortality risk among kidney cancer survivors with higher MVPA, but confidence intervals included the null.
Kidney cancer survivors: HR, 0.51 (95% CI, 0.22-1.18) for >15.0 to 22.5 MET-h/wk vs 0 MET-h/wk.
The confidence interval included the null value of 1.0, indicating the association was not statistically significant.
The direction of the point estimate was consistent with a potential protective association.
Results
Meeting MVPA guidelines after a cancer diagnosis was associated with lower cancer mortality risk among lung and rectal cancer survivors, even among those who were inactive before diagnosis.
The reference group was survivors who did not meet MVPA guidelines before or after diagnosis.
Lung cancer survivors who met guidelines after diagnosis (regardless of pre-diagnosis activity): HR, 0.58 (95% CI, 0.47-0.71).
Rectal cancer survivors who met guidelines after diagnosis (regardless of pre-diagnosis activity): HR, 0.51 (95% CI, 0.32-0.83).
This analysis examined changes in physical activity before vs after diagnosis as a secondary outcome.
Methods
The pooled analysis included 17,141 cancer survivors across 6 prospective cohorts with a mean follow-up of 10.9 years.
The 6 cohorts were: Cancer Prevention Study-II Nutrition Cohort, Health Professionals Follow-Up Study, NIH-AARP Diet and Health Study, Nurses' Health Study, Nurses' Health Study II, and Women's Health Study.
Mean (SD) age of participants was 67 (8) years; 60% were female.
Baseline data were collected from 1976 through 1997; data were analyzed from June 2023 to March 2024.
Mean (SD) follow-up was 10.9 (7.0) years.
Cancer types studied were bladder, endometrial, kidney, lung, oral cavity, ovarian, and rectal cancer.
Results
No statistically significant association between post-diagnosis MVPA and cancer mortality was observed for ovarian cancer survivors in this study.
Ovarian cancer was one of the 7 cancer types included in the pooled analysis.
The abstract does not report a significant hazard ratio for ovarian cancer, distinguishing it from the cancers with reported significant or near-significant associations.
The study population included survivors of 7 cancers 'not commonly studied' for the physical activity-survival association.
Rees-Punia E, Teras L, Newton C, Moore S, Lee I, Bates-Fraser L, et al.. (2026). Leisure-Time Physical Activity and Cancer Mortality Among Cancer Survivors.. JAMA network open. https://doi.org/10.1001/jamanetworkopen.2025.56971