1908P - Grading the evidence for physical activity and all outcomes in cancer survivors: An umbrella review of more than 700 meta-analytic associations

Background

To refine future physical activity guidelines for cancer survivors, that have remained mostly generic until now, we performed an umbrella review of meta-analyses for physical activity in survivors of any cancer type and for every studied outcome in the literature.

Methods

We searched the Medline and Scopus databases in August 2023. Meta-analyses showing nominally statistically significant associations were categorized into four evidence groups: strong, highly suggestive, suggestive, and weak.

Results

In total, 101 publications reporting 740 meta-analytic comparisons were included. Notably, 427 meta-analyses pertained to breast, 104 to prostate, 58 to hematological, 79 to colorectal and 54 to lung cancer survivors. Overall, 16 associations were judged to provide strong evidence and 10 highly suggestive evidence, while 93 suggestive evidence. In breast cancer survivors, there was strong and highly suggestive evidence that post-diagnosis physical activity is associated with lower all-cause mortality, recurrence, cancer-related fatigue, depression, and better mental health, body strength, aerobic capacity, and weight loss. In prostate cancer survivors, strong evidence was identified for the positive association of post-diagnosis physical activity with cardiovascular fitness, cancer-specific quality of life and fatigue amelioration. In colorectal cancer survivors, strong and highly suggestive evidence supported the association of post-diagnosis physical activity and post-diagnosis recreational physical activity with lower all-cause mortality. In lung cancer survivors, strong evidence supported the association of preoperative exercise for reduction of patients’ hospital length of stay. Suggestive evidence was identified linking post-diagnosis physical activity with ameliorating further medical, quality of life and strength outcomes for breast, prostate, lung, colorectal, head and neck, hematological and childhood cancers.

Conclusions

This grading of the entirety of the available evidence can further facilitate robust introduction of targeted exercise prescription by cancer type and for specific outcomes in oncology care.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.