Physical activity and health-related quality of life in young adult cancer survivors: a Canadian provincial survey

Objectives Physical activity (PA) improves health-related quality of life (HRQL) in several cancer survivor groups but no studies have focused on young adult cancer survivors (YACS). This study determined the prevalence of PA in YACS and examined dose-response associations with HRQL. Methods A random sample of 2,000 YACS between the ages of 20-44 were identified through a Canadian provincial cancer registry and mailed a survey that included the Leisure-Time Exercise Questionnaire, the Medical Outcomes Study 36-Item Short Form (SF36) survey, and several validated psychosocial scales. The primary endpoint was the physical component summary (PCS) of the SF36. Results Completed questionnaires were received from 588 YACS. In terms of PA prevalence, 23% were completely sedentary, 25% were insufficiently active, 22% were active within public health guidelines, and 29% were active above public health guidelines. Analysis of covariance adjusted for important medical and demographic covariates showed a statistically significant and clinically meaningful dose-response association between PA and the PCS that spanned 6.3 points (95% confidence interval [CI] 3.7 to 8.8; p < 0.001) from completely sedentary to within guidelines. Similar associations were found for the mental component summary scale (p = 0.002), depression (p < 0.001), stress (p < 0.001) and self-esteem (p < 0.001). Associations between PA and HRQL were stronger for YACS that had previously received chemotherapy. Conclusions PA is strongly associated with HRQL in YACS but only half of YACS are meeting public health guidelines and almost a quarter are completely sedentary. Randomized controlled trials examining intervention strategies to increase PA and improve health outcomes in this understudied patient population are warranted.