Korean J Sports Med.  2020 Jun;38(2):101-109. 10.5763/kjsm.2020.38.2.101.

Associations between Physical Activity Level and Metabolic Risk Factors in Gynecological Cancer Survivors

• Lee SH
• Kim JW
• Seong SJ
• Kim YS

• KMID: 2502522
• DOI: http://doi.org/10.5763/kjsm.2020.38.2.101

Abstract

Purpose
This study aimed to investigate the associations between physical activity (PA), health-related fitness, and metabolic risk factors in Korean gynecological cancer survivors using propensity score matching.
Methods
A cross-sectional analysis was performed using national representative data between 2015 and 2018 from the Korea National Health and Nutrition Examination Survey (KNHANES VI3 and VI1–3). PA was self-reported through the global PA questionnaire, and health-related fitness was measured using handgrip strength and resting heart rate. Metabolic risk factors were measured by performing blood analyses, including fasting glucose, total cholesterol, and triglyceride levels, and blood pressure.
Results
The total number of subjects was 268 (gynecological cancer, n=134; non-cancer, n=134). The results showed that the gynecological cancer survivors (time since diagnosis, ＜5 years and ≥5 years) participated in less amounts of weekly total moderate-to-vigorous intensity PA (160.0±170.1 vs. 144.6±177.3 vs. 334.1±191.3 min/wk; p＜0.001), travel PA (94.5±119.3 vs. 109.4±143.9 vs. 215.7±170.7 min/wk; p＜0.001), and walking (190.7±174.5 vs. 258.8±280.8 vs. 444.5±434.7 min/wk; p＜0.001) than did the non-cancer population. Moreover, the gynecological cancer survivors who met the aerobic PA guidelines had significantly lower fasting glucose (p=0.035) and triacylglyceride levels (p=0.013), and systolic blood pressure (p=0.035) than the non-active participants.
Conclusion
The PA of the gynecological cancer survivors was lower than that of the general population. Aerobic PA was significantly associated with lower levels of metabolic disturbances in Korean gynecological cancer survivors.

Keyword

Exercise; Gynecology; Nutrition survey; Risk factor

Reference

1. Statistics Korea. Cancer registration statistics [Internet]. Statistics Korea;Daejeon: Available from: http://kosis.kr/index/index.do. cited 2020 Feb 21.

2. Michaan N, Park SY, Won YJ, Lim MC. 2018; Comparison of gynecologic cancer risk factors, incidence and mortality trends between South Korea and Israel, 1999-2013. Jpn J Clin Oncol. 48:884–91. DOI: 10.1093/jjco/hyy111. PMID: 30113642.

3. Hewitt M, Rowland JH, Yancik R. 2003; Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci. 58:82–91. DOI: 10.1093/gerona/58.1.M82. PMID: 12560417.

4. Scott JM, Nilsen TS, Gupta D, Jones LW. 2018; Exercise therapy and cardiovascular toxicity in cancer. Circulation. 137:1176–91. DOI: 10.1161/CIRCULATIONAHA.117.024671. PMID: 29530893. PMCID: PMC6028047.

5. Ye F, Moon DH, Carpenter WR, et al. 2017; Comparison of patient report and medical records of comorbidities: results from a population-based cohort of patients with prostate cancer. JAMA Oncol. 3:1035–42. DOI: 10.1001/jamaoncol.2016.6744. PMID: 28208186. PMCID: PMC5824220.

6. Wu AH, Kurian AW, Kwan ML, et al. 2015; Diabetes and other comorbidities in breast cancer survival by race/ethnicity: the California Breast Cancer Survivorship Consortium (CBCSC). Cancer Epidemiol Biomarkers Prev. 24:361–8. DOI: 10.1158/1055-9965.EPI-14-1140. PMID: 25425578. PMCID: PMC4523272.

7. Jung KW, Won YJ, Kong HJ, Lee ES. 2019; Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2016. Cancer Res Treat. 51:417–30. DOI: 10.4143/crt.2019.138. PMID: 30913865. PMCID: PMC6473271.

8. Zaorsky NG, Churilla TM, Egleston BL, et al. 2017; Causes of death among cancer patients. Ann Oncol. 28:400–7. DOI: 10.1093/annonc/mdw604. PMID: 27831506. PMCID: PMC5834100.

9. Danaei G, Vander Hoorn S, Lopez AD, Murray CJ, Ezzati M. Comparative Risk Assessment Collaborating Group (Cancers). 2005; Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors. Lancet. 366:1784–93. DOI: 10.1016/S0140-6736(05)67725-2. PMID: 16298215.

10. Schmitz KH, Courneya KS, Matthews C, et al. 2010; American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 42:1409–26. DOI: 10.1249/MSS.0b013e3181e0c112. PMID: 20559064.

11. Campbell KL, Winters-Stone KM, Wiskemann J, et al. 2019; Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc. 51:2375–90. DOI: 10.1249/MSS.0000000000002116. PMID: 31626055.

12. Rock CL, Doyle C, Demark-Wahnefried W, et al. 2012; Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 62:243–74. DOI: 10.3322/caac.21142. PMID: 22539238.

13. Min JH, Kim JY, Jeon JY. 2015; The characteristics Korean cancer patients' physical activity participation: focus on five major cancers: The Korea National Health and Nutrition Examination Survey 2009-2013. Korean J Phys Educ. 54:389–97.

14. Paek J, Choi YJ. 2019; Association between hand grip strength and impaired health-related quality of life in Korean cancer survivors: a cross-sectional study. BMJ Open. 9:e030938. DOI: 10.1136/bmjopen-2019-030938. PMID: 31501128. PMCID: PMC6738715.

15. Lee J, Lee C, Min J, et al. 2019; Development of the Korean Global Physical Activity Questionnaire: reliability and validity study. Glob Health Promot. 1757975919854301. DOI: 10.1177/1757975919854301. PMID: 31375056.

16. Austin PC. 2011; An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res. 46:399–424. DOI: 10.1080/00273171.2011.568786. PMID: 21818162. PMCID: PMC3144483.

17. Lee MK, Min JH, Justin J. 2016; Physical activity participation and body composition in colorectal and gastric cancer survivor. Korean J Phys Educ. 55:465–72.

18. Aziz NM. 2007; Cancer survivorship research: state of knowledge, challenges and opportunities. Acta Oncol. 46:417–32. DOI: 10.1080/02841860701367878. PMID: 17497308.

19. Thomson CA, Crane TE, Miller A, Garcia DO, Basen- Engquist K, Alberts DS. 2016; A randomized trial of diet and physical activity in women treated for stage II-IV ovarian cancer: rationale and design of the Lifestyle Intervention for Ovarian Cancer Enhanced Survival (LIVES). An NRG Oncology/Gynecologic Oncology Group (GOG-225) Study. Contemp Clin Trials. 49:181–9. DOI: 10.1016/j.cct.2016.07.005. PMID: 27394382. PMCID: PMC5108358.

20. Courneya KS. 2014; Physical activity and cancer survivorship: a simple framework for a complex field. Exerc Sport Sci Rev. 42:102–9. DOI: 10.1249/JES.0000000000000011. PMID: 24508735.

21. Coughlin SS, Calle EE, Teras LR, Petrelli J, Thun MJ. 2004; Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults. Am J Epidemiol. 159:1160–7. DOI: 10.1093/aje/kwh161. PMID: 15191933.

22. Currie CJ, Poole CD, Jenkins-Jones S, Gale EA, Johnson JA, Morgan CL. 2012; Mortality after incident cancer in people with and without type 2 diabetes: impact of metformin on survival. Diabetes Care. 35:299–304. DOI: 10.2337/dc11-1313. PMID: 22266734. PMCID: PMC3263862.

23. Sturgeon KM, Deng L, Bluethmann SM, et al. 2019; A population- based study of cardiovascular disease mortality risk in US cancer patients. Eur Heart J. 40:3889–97. DOI: 10.1093/eurheartj/ehz766. PMID: 31761945.

24. Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. 2011; Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 13:R64. DOI: 10.1186/bcr2901. PMID: 21689398. PMCID: PMC3218953.

25. Bao PP, Zheng Y, Nechuta S, et al. 2013; Exercise after diagnosis and metabolic syndrome among breast cancer survivors: a report from the Shanghai Breast Cancer Survival Study. Cancer Causes Control. 24:1747–56. DOI: 10.1007/s10552-013-0252-7. PMID: 23860950. PMCID: PMC3858324.

26. Gorzelitz J, Costanzo ES, Spencer RJ, Rumble M, Rose SL, Cadmus-Bertram L. 2019; Longitudinal assessment of post-surgical physical activity in endometrial and ovarian cancer patients. PLoS One. 14:e0223791. DOI: 10.1371/journal.pone.0223791. PMID: 31618279. PMCID: PMC6795433.