Cancer survival has improved markedly over time, mainly due to advances in cancer diagnosis and treatment. With increasing life expectancy, cancer survivors are now experiencing the health impact of chronic diseases, such as diabetes and cardiovascular disease.
However, whether cancer-specific survival is modified by chronic disease status is poorly understood. Also, whether lifestyle factors such as physical activity and sedentary behavior differentially affect cancer survival among those with and without chronic disease is unknown.
We are excited to help better understand the science behind surviving cancer with funding from World Cancer Research Fund, potentially broadening the scope of cancer prevention recommendations by examining the relations of physical activity and sedentary behavior to cancer survival among those living with chronic conditions. – Prof Dr Michael Leitzmann
The combined impact of physical activity, sedentary behaviour and cardiometabolic comorbidities on cancer risk and survival among cancer survivors
Cancer and other chronic diseases often share common risk factors, including low physical activity, and they tend to occur at the same time; in other words are ‘comorbid’, among the same individuals. The most common comorbidities for cancer include cardiovascular diseases (CVD) and diabetes. It is thought that those with a comorbidity are more likely to develop cancer, even if they are physically active compared with someone without a comorbidity who lives a sedentary lifestyle.
Low physical activity and prolonged sedentary behaviour have also been linked to poorer survival in people with cancer. Cancer survivors who have pre-existing comorbidities have lower survival rates than those without diabetes.
Aims and objectives
This project aims to find out whether physical activity and sedentary behaviours are associated with similar risk of developing cancer and dying early from cancer among individuals with and without CVD and/or diabetes.
We will specifically investigate cancers that have been linked to physical activity, sedentary behaviour, and the comorbidities CVD and/or diabetes. These cancers include large bowel cancer, breast cancer, pancreatic cancer and endometrial cancer.
How it will be done
We will include study participants who are free of cancer and comorbidities at the start of the study and follow them up during adult life and eventual development of comorbidities, cancer, or death. We will compare risk of cancer development and early death associated with physical activity and sedentary time between individuals with and without CVD and/or diabetes.
To understand the biological processes, we will investigate whether different physical activity/sedentary patterns can be linked to changes in blood concentrations of small molecules and cancer risk, and whether they differ according to comorbidity status. The study will use genetic analysis to determine if there is a causal link.
The outcomes of this project will help to broaden the scope of cancer prevention recommendations for people living with chronic conditions such as diabetes and CVD, but also to identify susceptible groups of individuals who could benefit from more targeted physical activity interventions.
Stein, M.J., Baurecht, H., Sedlmeier, A.M. et al. Association between circadian physical activity patterns and mortality in the UK Biobank. Int J Behav Nutr Phys Act 20, 102 (2023)