Decreased motile activity in cancer survivors is associated with an increased risk of death

Bottom Line: Cancer survivors were at greater risk of reduced motile function, which was associated with an increased risk of death.

Journal in which the study was published: Cancer epidemiology, biomarkers & prevention, journal of the American Society for the Study of Cancer

Author: Elizabeth Salerno, PhD, MPH, professor of surgery at the University of Washington School of Medicine in St. Louis. Louis, who conducted the research at the National Cancer Institute

Background: The diagnosis and treatment of cancer has been shown to be linked to poor functional health for common cancers, such as those of breast and prostate, but little is known about the link for other cancers, Salerno explained.

As cancer survivors live longer than ever before, understanding how the diagnosis and treatment of a wide range of cancers can affect motor activity – a risk factor – could help. potentially changing – leading to new treatment and rehabilitation strategies to improve the health of these patients.. “

Elizabeth Salerno, PhD, MPH, Associate Professor of Surgery, School of Medicine, University of Washington in St. Louis. Louis

How the Study Was Conducted: In this study, Salerno and colleagues investigated whether reduced movement activity was associated with different types of cancer, and whether movement activity was linked to survival. Salerno and colleagues analyzed data from the National Institute of Retirement Health (AARP) Diet and Health Survey, which included more than 500,000 AARP members between the ages of 51 and 70.

AARP members received a questionnaire assessing demographics, medical history, and diet between the years 1995 and 1996 and a follow-up questionnaire between 2004 and 2006 assessing health status, lifestyle, and mobility activity, among other things. Movement function was determined by self-reported walking speed and mobility impairment.

Results: After banning individuals for error reporting and incomplete questionnaires, the final sample included 30,403 cancer survivors and 202,732 people who were never diagnosed with cancer. The median age of the participants was 61.8 years, and the majority of individuals were classified as white (92.4 percent), male (56.7 percent), and in health. very good (56.4 per cent). A wide range of cancer types were represented in the study population, including cancers of the breast, respiratory system, lymphatic system, skin, genitourinary tract, and gastrointestinal tract, among others.

Salerno and colleagues found that cancer survivors were 42 percent more likely to report walking at the slowest pace compared to individuals without a cancer diagnosis. After adjusting for demographics, health status, cancer type, and body index, people who survived cancer had a 24 percent greater risk of mobility disability. Lower motility was associated with several types of cancer, and the strongest associations were observed for survivors of respiratory or oral cancer.

Slower walking speed and mobility disability were also associated with an increased risk for all-cause and specific cancer deaths in cancer survivors after adjusting for cancer demographics and characteristics. Survivors who reported walking at the slowest pace had more than two times greater risk of all-cause mortality and specific cancers compared to survivors who reported fast walking speeds. Similarly, those who survived with a mobility disability were 80 percent and 64 percent more at risk of specific mortality and specific cancer, respectively.

While slower walking speed and mobility impairment also increased the risk of mortality in non-cancerous individuals, Salerno and colleagues found that the link between circulatory function and mortality was greater for cancer survivors than for cancer survivors. e for cancer-free individuals.

When compared to individuals without a cancer diagnosis who reported fast walking speed, cancer survivors with the slowest walking speed had a more than 10-fold risk of death; those without cancer with the slowest walking speed had tripled their risk of death.

Author comments: “Our findings suggest that functional health may be adversely affected by a wide range of cancer diagnoses and could be an important determinant of survival,” Salerno said. “There is still much to learn about these complex relationships, but our findings highlight the importance of monitoring, and even targeting, post-cancer mobile activity for survival benefits. , especially in older cancer survivors. “

Future research from Salerno and colleagues will focus on understanding why some cancers had stronger links with mobile function and stronger links between mobile function and mortality. “More information about specific behavioral, biological, and cancer factors from before, during, and after diagnosis and treatment will be important to better identify these associations in specific types of cancer,” she said.

Study limitations: The limitation of the study is that all data on walking speed and mobility disability were self-reported. While self-report is important for collecting extensive study data, it may not be as accurate as clinical measures, Salerno explained.

In the future, Salerno is interested in studying the correlation between self-reported mobile activity and more targeted measures in the context of cancer and mortality. Additional limitations include the lack of complete treatment data, the fact that the number of survivors was relatively healthy and that disease was predominantly early stage, and the potential for additional congested variables that were not. was controlled in the analyzes.