Article
Physical activity, television viewing, and mortality among hematologic cancer survivors
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Authors
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Daniela Schmid
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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Gundula Behrens
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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Carmen Jochem
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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Hannah Arem
- U.S. Agency for International Development, Bureau for Global Health, Washington DC, USA, Washington, USA
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Charles Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA, USA
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Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| Published: | August 8, 2016 |
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Outline
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Background: Cancer patients and clinicians seek information about lifestyle modification to improve health and longevity after cancer diagnosis and treatment. Data on physical activity and mortality among hematologic cancer patients are sparse and information about television (TV) viewing and hematologic cancer survival is unavailable.
Design and methods: We examined the relations of self-reported physical activity and TV viewing time before and after hematologic cancer diagnosis to mortality among 5,182 U.S. adults aged 50–71 years from the NIH-AARP Diet and Health Study cohort who survived a first hematologic cancer including, Hodgkin lymphoma, Non-Hodgkin lymphoma, myeloma, and leukemia.
Results: For the pre-diagnosis physical activity and TV viewing analysis, we confirmed 2,585 and 2,606 deaths from any cause, respectively. In the post-diagnosis physical activity and TV viewing analysis, 613 and 577 events were considered, respectively. Comparing high versus low physical activity levels (≥4 hrs/wk versus <1 hr/wk), pre-diagnosis physical activity and post-diagnosis physical activity were related to 19% (multivariable-adjusted hazard ratio (HR)=0.81, 95% confidence interval (CI)=0.74-0.89, p for trend <0.001; additional adjustment for body mass index (BMI): HR=0.84, 95% CI=0.77-0.93, p for trend=0.002) and 40% (multivariable-adjusted HR=0.60, 95% CI=0.49-0.73, p for trend<0.001; additional adjustment for BMI: HR=0.61, 95% CI=0.49-0.74, p for trend <0.001) reduced risk of all-cause mortality, respectively. TV viewing before diagnosis was related to 14% increased risk of mortality (multivariable-adjusted HR=1.14, 95% CI=1.02-1.28, p for trend=0.01), but the relation was attenuated and no longer statistically significant after additional control for BMI (HR=1.11, 95% CI=0.99-1.24, p for trend=0.06). TV viewing after diagnosis was positively related to mortality (HR=1.22, 95% CI=0.99- 1.51, p for trend=0.12), but the association did not reach statistical significance. When evaluated by hematologic cancer type (Non-Hodgkin lymphoma, myeloma, and leukemia), physical activity before and after diagnosis was significantly inversely associated with mortality among survivors of Non-Hodgkin lymphoma and leukemia, whereas a significant inverse association was noted for post-diagnosis physical activity among myeloma survivors. Pre-diagnosis TV viewing was related to increased risk of mortality among Non-Hodgkin lymphoma survivors, whereas post-diagnosis TV viewing was associated with increased risk of mortality among leukemia survivors.
Conclusions: Our study suggests that increased physical activity before and after hematologic cancer diagnosis improves survival. By comparison, pre-diagnosis TV viewing was suggestively associated with increased risk of mortality among hematologic cancer survivors. However, associations with physical activity and TV viewing vary notably by hematologic cancer type.
