Physical Fitness and Physical Activity in Adolescent Childhood Cancer Survivors and Controls: The PACCS Study

This study aimed to compare physical fitness, function, and physical activity (PA) in adolescent childhood cancer survivors (CCSs) to age- and sex-matched controls and across different cancer diagnoses.

This multicenter cross-sectional study (Physical Activity among Childhood Cancer Survivors) included CCSs aged 9-18 yr (≥1-yr after cancer treatment) and age- and sex-matched controls. Physical fitness tests included cardiorespiratory fitness (V̇O 2max ) and muscular strength (maximal isometric handgrip, knee extension, and chest press). Physical function tests included a 1-min sit-to-stand test (STS) and countermovement jump (CMJ). PA was measured by accelerometer for 7 d. We used linear mixed-effects models to compare outcomes between CCSs and controls, and across diagnostic groups.

We included 157 CCSs and 113 controls aged 13.4 ± 2.6 yr (mean ± SD). Cancer types were leukemia ( n = 78), central nervous system (CNS) tumors ( n = 18), lymphoma ( n = 16), and other solid tumors ( n = 45). CCSs had lower V̇O 2max (marginal mean (95% confidence interval), 41.7 (38.4-45.0) vs 46.4 (42.9-49.8) mL·kg -1 ·min -1 ; P < 0.001), knee-extension strength (35.4 (34.1-36.8) vs 38.2 (36.7-39.7) kg, P = 0.003), chest-press strength (30.0 (28.4-31.6) vs 32.8 (31.0-34.7) kg, P = 0.007), STS repetitions (57.5 (55.8-59.3) vs 60.0 (58.0-62.0) P = 0.017), and CMJ height (22.1, (20.5-23.8) vs 24.9 (23.2-26.6) cm, P < 0.001). PA levels and sedentary time were similar in both groups (8513 (7993-9034) vs 9000 (8404-9596) steps per day, P = 0.174, respectively). Survivors of CNS tumors had the lowest values for V̇O 2max , muscular strength, physical function, and PA.

Despite no significant difference in PA levels, adolescent CCSs had 4.2% to 11% lower physical fitness and function compared with controls, where survivors of CNS tumors performed the poorest.