Is exercise associated with lower risk of death for adult survivors of childhood cancer?

Bottom Line: Vigorous exercise is associated with reductions in the risk of death among adult survivors of childhood cancer.

Why The Research Is Interesting: In the general population, a healthy lifestyle that includes regular exercise is associated with a reduced risk of death. It is unknown whether that applies to adult survivors of childhood cancer who have an elevated risk of death because of the late effects of cancer treatment.

Who and When: 15,450 adult survivors of cancer diagnosed before age 21 at hospitals in the United States and Canada between 1970 and 1999 and enrolled in the Childhood Cancer Survivor Study

What (Study Measures): Self-reported vigorous exercise in metabolic equivalent task (MET) hours per week (exposures); all cause-mortality (primary outcome)

Study Design: This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors: Jessica M. Scott, Ph.D., and Lee W. Jones, Ph.D., of Memorial Sloan Kettering Cancer Center, New York, and coauthors

Results: Vigorous exercise for adult survivors of childhood cancer was associated with reductions in risk of death; in a subset of these survivors, increased exercise (an average of nearly 8 MET-hours per week) over an eight-year period was associated with a lower risk of death compared with maintaining a low level of exercise.

Limitations: Exercise was self-reported by a single item that evaluated only vigorous exercise

Study Conclusions: Our findings indicate that regular vigorous exercise, as well as an increase in exercise, is associated with significant reductions in the risk of mortality in adult survivors of childhood cancer. These findings may be of importance for the large and rapidly growing global population of adult survivors of childhood cancer at substantially higher risk of mortality due to multiple competing risks.

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(doi:10.1001/jamaoncol.2018.2254)

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