Accelerometer-Determined Physical Activity Among Colon Cancer Survivors: Associations with Health-Related Quality of Life and Fatigue

Purpose: The primary purpose of this study was to determine associations of accelerometer-assessed moderate- to vigorous-intensity physical activity (MVPA) and sedentary time with health-related quality of life (HRQoL) and physical function and well-being in colon cancer survivors.

Methods: Colon cancer survivors (N=181) from Alberta, Canada (n=92) and Western Australia (n=89) completed a mailed survey that assessed HRQoL (Functional Assessment of Cancer Therapy-Colorectal), physical function and well-being (Trial Outcome Index-Colorectal), and relevant covariates. MVPA and sedentary time were assessed using the Actigraph® GT3X+ accelerometer (60 second epochs) via a seven-day monitoring protocol. Average daily MVPA and sedentary time was corrected for wear time and then examined as quartiles (Q).

Results: Adjusting for relevant demographic, behavioural, and clinical covariates, a significant difference in HRQoL scores emerged between Q1 and Q4 (Mdiff=12.1, p=0.014). For physical function and well-being (TOI-C), a significant difference emerged between Q1 and Q4 (Mdiff=9.1, p=0.005). Significant differences were also observed for between Q1 and Q3 (Mdiff=2.6, p=0.015) and Q1 and Q4 (Mdiff=3.4, p=0.001) for colorectal cancer-specific concerns. There were no statistically significant associations of sedentary time with HRQoL, physical function and well-being, fatigue, or colorectal cancer-specific concerns.

Conclusion: Objectively measured MVPA, but not sedentary time, was associated with better HRQoL and physical function and well-being in colon cancer survivors. Differences exceeded contemporary cutpoints for determining clinically important differences for HRQoL (>5 points) and physical function and well-being (>4 points).