Date Published: June 12, 2018
Publisher: Public Library of Science
Author(s): Daniela Schmid, Charles E. Matthews, Michael F. Leitzmann, Sabine Rohrmann.
The relations of physical activity and sedentary behavior to mortality risk among patients with renal cell cancer have not yet been evaluated.
We conducted a prospective cohort study among 667 renal cell cancer survivors aged 50–71 years of the National Institutes of Health (NIH)-AARP Diet and Health Study with a median follow-up time of 7.1 years. Post-diagnosis physical activity, TV viewing, and total sitting time were assessed using self-administered questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were estimated using Cox proportional hazards models.
Increasing levels of moderate to vigorous physical activity were related to decreased risk of overall mortality [multivariable-adjusted HRs for <1 hr/wk (reference), 1 to 3 hrs/wk, ≥3 to <7 hrs/wk, and ≥7 hrs/wk = 1.0, 1.16, 0.94, and 0.60 (95% CI = 0.38–0.96; p-trend = 0.03)]. In contrast, television viewing was associated with increased risk of overall mortality in the age- and sex-adjusted model (HR for >4 hrs/d vs. 0 to 2 hrs/d = 1.52, 95% CI = 1.02–2.26; p-trend = 0.04), but the relation was attenuated following further control for other covariates (multivariable-adjusted HR = 1.44, 95% CI = 0.92–2.24; p-trend = 0.11). Total sitting time was unrelated to all-cause mortality.
Among renal cancer patients, moderate to vigorous physical activity is associated with decreased risk of overall mortality. Clinicians should consider discussing the potential benefits of physical activity for longevity among survivors of renal cell cancer.
In 2017, an estimated 63,990 new cases of kidney and renal pelvis cancer occurred in U.S. adults . Although renal cell cancer is known to be the most lethal urologic malignancy , the estimated five-year survival rate of kidney and renal pelvis cancer among U.S. adults notably improved from 50% between 1975 and 1977 to 74% between 2004 and 2010, likely a consequence of improved cancer diagnosis and treatment. Therefore, the impact of recognizing modifiable risk factors after diagnosis resulting in improved survival is enormously high.
During a median follow-up time of 7.1 years, we documented 175 deaths for the physical activity analysis and 163 deaths for the TV viewing analysis, of which 57 and 53 were due to renal cell cancer, respectively. Age-standardized characteristics for moderate to vigorous physical activity and TV viewing after diagnosis are shown in Table 1. Participants with greater physical activity levels were less likely to be current smokers and to have a history of diabetes mellitus than the least active participants. By comparison, individuals reporting prolonged TV viewing were more likely to be current smokers and to have histories of diabetes mellitus and hypertension than less sedentary individuals.
In this first investigation of physical activity in relation to risk of mortality among survivors of renal cell cancer, increasing levels of moderate to vigorous physical activity were associated with decreased risk of all-cause mortality, regardless of the level of sedentary behavior. In contrast, prolonged time spent sedentary was unrelated to risk of mortality.