Poster Presentation Cancer Survivorship 2017

Physical activity in survivors of childhood cancer: results from a long-term follow-up study, systematic review and meta-analysis (#66)

David Mizrahi 1 2 , Joanna Fardell 2 3 , David Simar 1 , Claire Wakefield 2 3 , Briana Clifford 1 , Qishan Lim 3 , Veronica Quinn 2 3 , Jordana McLoone 2 3 , Frank Alvaro 4 , Tom Walwyn 5 , Richard Cohn 2 3
  1. School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
  2. Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children’s Hospital, Sydney, NSW, Australia
  3. Discipline of Paediatrics, School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
  4. Department of Paediatric Oncology, John Hunter Children’s Hospital, Newcastle, NSW, Australia
  5. Department of Oncology and Haematology, Princess Margaret Hospital for Children, Perth, WA, Australia

Aims: This study aimed to assess physical activity levels in childhood cancer survivors (CCS), compare these to recommended guidelines, and investigated the feasibility of distance-delivered physical activity interventions amongst CCS.

Methods: CCS (aged≥16) and parents (survivors aged<16) from 11 hospitals in Australia and New Zealand participated in this study. Participants self-reported their moderate-vigorous physical activity (MVPA). This was compared to American Cancer Society’s physical activity guidelines (150 minutes/week for adults, 300 minutes/week for children). A systematic review and meta-analysis were conducted to determine the feasibility (adherence, retention and recruitment rates) and effect of distance-delivered interventions on physical activity levels, physical and psychological function after intensive treatment. 

Results: 329 CCS (mean age=27.7±7.2years, 20.3±8.3years since diagnosis) and 254 parents of CCS (mean age=14.0±2.8years, 10.9±2.9years since diagnosis) participated. Adult CCS reported mean MVPA of 115.9±129.8 minutes/week and children had MVPA of 231.3±227.8 minutes/week, which was in both cases lower than recommended guidelines (both p<0.001). Only 31.3% of adults and 29.1% of children achieved recommended MVPA guidelines. Our systematic review included 13 studies (n=270 participants), while 5 (n=115 participants) were included in the meta-analysis. Distance-delivered physical activity interventions were feasible in CCS (mean recruitment rate=64%, retention rate=85%, adherence rate=88%), and significantly increased physical activity levels from baseline to post intervention (p=0.019). Participation in physical activity interventions displayed a positive effect on physical function (p=0.002) and psychological outcomes (p=0.001).

Conclusions: Over two-thirds of child and adult CCS are not achieving recommended levels of physical activity. Strategies including education and earlier monitoring are needed to increase physical activity levels and lower the risk of cardiovascular and metabolic co-morbidity. CCS may experience barriers including fatigue, access to facilities or lack of guidance, but our investigation into distance-delivered interventions to increase physical activity levels suggests that such interventions could represent a viable option to tackle this important issue.