Determinants of Physical Activity among Patients with Colorectal Cancer: From Diagnosis to Five Years after Diagnosis

Karel C. Smit, Jeroen W.G. Derksen, Rebecca K. Stellato, Anne-Sophie van Lanen, Evertine Wesselink, Eric J.T. Belt, Marissa Cloos-van Balen, Peter Paul L.O. Coene, Jan Willem T. Dekker, Jan Willem de Groot, Annebeth W. Haringhuizen, Henk K. van Halteren, Tjarda T. van Heek, Helgi H. Helgason, Mathijs P. Hendriks, Ignace H.J.T. de Hingh, Ronald Hoekstra, Danny Houtsma, Johan J.B. Janssen, Niels KokJoop L.M. Konsten, Maartje Los, Martijn R. Meijerink, Leonie J.M. Mekenkamp, Koen C.M.J. Peeters, Marco B. Polée, Ron C. Rietbroek, Anandi H.W. Schiphorst, Ruud W.M. Schrauwen, Jennifer Schreinemakers, Mark P.S. Sie, Lieke Simkens, Eric J.A. Sonneveld, Frederiek Terheggen, Liselot Valkenburg-van Iersel, Wouter J. Vles, Daria K. Wasowicz-Kemps, Johannes H.W. de Wilt, Dieuwertje E. Kok, Renate M. Winkels, Ellen Kampman, Fränzel J.B. van Duijnhoven, Miriam Koopman, Anne M. May*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Introduction: Physical activity (PA) is associated with higher quality of life and probably better prognosis among colorectal cancer (CRC) patients. This study focuses on determinants of PA among CRC patients from diagnosis until five years post-diagnosis.
Methods: Sociodemographic and disease-related factors of participants of two large CRC cohort studies were combined. Moderate-to-vigorous PA during sport and leisure time (MVPA-SL) was measured at diagnosis (T0) and six, twelve, twenty-four, and sixty (T6 to T60) months post-diagnosis, using the SQUASH questionnaire. Mixed-effects models were performed to identify sociodemographic and disease-related determinants of MVPA-SL, separately for stage I-III colon (CC), stage I-III rectal cancer (RC), and stage IV CRC (T0 and T6 only). Associations were defined as consistently present when significant at ≥4 timepoints for the stage I-III subsets. MVPA-SL levels were compared with an age- and sex-matched sample of the general Dutch population.
Results: In total, 2905 CC, 1459 RC and 436 stage IV CRC patients were included. Patients with higher fatigue scores, and women compared to men had consistently lower MVPA-SL levels over time, regardless of tumor type and stage. At T6, having a stoma was significantly associated with lower MVPA-SL among stage I-III RC patients. Systemic therapy and radiotherapy were not significantly associated with MVPA-SL changes at T6. Compared to the general population, MVPA-SL levels of CRC patients were lower at all timepoints, most notably at T6.
Conclusions: Female sex and higher fatigue scores were consistent determinants of lower MVPA-SL levels among all CRC patients, and MVPA-SL levels were lowest at six months post-diagnosis. Our results can inform the design of intervention studies aimed at improving PA, and guide healthcare professionals in optimizing individualized support.
Original languageEnglish
JournalMedicine and Science in Sports and Exercise
Issue number1
Publication statusPublished - 18 Mar 2024


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