Every move matters: physical activity, walking, sedentary behavior, and endometrial cancer survival

Excess body fat increases endometrial cancer risk, and moderate-to-vigorous physical activity (MVPA) lowers risk, but the relationship between post-diagnosis MVPA, walking, sedentary time (SED), and endometrial cancer survival is under-researched.

Cancer Prevention Study-II participants self-reported post-diagnosis MVPA (MET hour/week, h/wk), walking (h/wk), and SED (h/wk). Meeting MVPA guidelines was defined as 7.5 to <15 MET h/wk. Walking was categorized as 0, <2, 2-6, or >6 h/wk. SED was divided into tertiles (T1-T3). Hazard ratios and 95% confidence intervals (HR, CI) are calculated using delayed-entry Cox models, adjusted for covariates.

We identified 1016 endometrial cancer survivors (mean BMI: 27.6, age at diagnosis: 72 years, 97% White, 71% college educated, 93% married). Over an average 13.5 years of follow-up, 511 deaths occurred (232 any cancer, 60 endometrial cancer). Compared to no MVPA, associations were not statistically significant, but point estimates suggest that higher amounts of MVPA [measured on average 1.2-year post-diagnosis] are potentially associated with lower all-cause mortality risk [doubling guidelines (HR: 0.71, 95% CI 0.50, 1.00)] but not total cancer mortality risk. Walking <2 h/wk was associated with higher all-cause mortality risk compared to no walking (HR: 1.45, 95% CI: 1.08, 1.96) but not cancer mortality risk. Limiting SED was not associated with survival.

This study suggests that higher amounts of MVPA may be associated with survival among older endometrial cancer survivors; however, further research is needed in larger/pooled cohorts with more cancer deaths.