Physical activity levels of women with breast cancer during and after treatment, a comparison with the Dutch female population

Abstract

Background: Physical activity has been shown to reduce side-effects of breast cancer and its treatment. As physical activity levels of patients with breast cancer are largely unknown, we investigated these levels and compared them to women from the general population.

Methods: In this prospective cohort study, physical activity levels of women with breast cancer participating in the UMBRELLA cohort were assessed at radiotherapy intake and thereafter every 6 months up to 3 years with the SQUASH questionnaire, which was also used in a random sample of the Dutch population. We compared physical activity levels (no activity, low, moderate or high levels of sports, leisure time or total activity) between patients and the Dutch female population using multinomial logistic regression. Standardized Prevalence Ratios (SPR) were calculated to compare adherence to Dutch physical activity guidelines.

Results: Women with breast cancer (n_baseline = 1655, n_{6 months} = 1414, n_{12 months} = 1186, n_{18 months} = 957, n_{24 months} = 744, n_{30 months} = 555, and n_{36 months} = 377) were less likely to spend time in physical activity compared to the general population (n = 11,710) until 3 years post-diagnosis, especially after 6 months (OR_{high-vs.-no activity} = 0.34, 95% CI: 0.28–0.41). From 12 months onwards, patients were more likely to perform sports compared to the general population, especially patients who underwent systemic therapy. Guideline adherence was significantly lower in patients at baseline and 6 months (SPR_baseline = 89, 95% CI: 82–97; SPR_{6 months} = 88, 95% CI: 81–96), and comparable to the general population at 12–36 months, especially in older women.

Conclusions: Physical activity levels in women with breast cancer during and after treatment were lower compared to the Dutch female population. Three years post-treatment, they were still less physically active, although they spend more time in sport activities. As about half of the patients did not perform any sports, physical activity needs to be stimulated during and after treatment.

Acknowledgments

The authors thank the study team of the UMBRELLA cohort at the department of Radiotherapy, Imaging Division and Julius Center for Health Sciences and Primary Care of the University Medical Center Utrecht (UMCU) for running the cohort and collecting the data. The authors also want to thank G.C.W. Wendel-Vos for assistance with the statistical analysis (SQUASH syntax).

Ethics approval

This study was conducted according to the principles of the Declaration of Helsinki (Forteleza, October 2013: http://www.wma.net/en/30publications/10policies/b3/).

Availability of data and material

The datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request. Under certain conditions, microdata from the Health Surveys are accessible for statistical and scientific research. For further information: [email protected].

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by a Veni grant from The Netherlands Organization for Health Research and Development (ZonMw 016.156.050). In addition, funding was provided by the department of Radiotherapy, Imaging Division of the UMCU, and the Department of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, UMCU.