Exploring exercise behavior, barriers, and facilitators among gynecologic cancer survivors: a cross-sectional study

Exercise is increasingly recognized as an important component of cancer survivorship care, offering physical and psychological benefits. However, limited data exist on exercise behavior and influencing factors among gynecologic cancer survivors in Southeast Asia.

To assess exercise knowledge, practices, facilitators, and barriers among gynecologic cancer survivors and identify factors associated with continued physical activity following treatment.

A cross-sectional study was conducted among 244 gynecologic cancer survivors attending follow-up care at Chiang Mai University Hospital between April and November 2024. Participants completed structured interviews using a validated questionnaire covering demographics, exercise knowledge and behaviors, and perceived facilitators and barriers. Clinical data were collected from medical records. Statistical analysis included descriptive statistics and logistic regression to identify factors associated with post-treatment exercise.

The most common cancer types were cervical (38.1%), endometrial (34.8%), and ovarian (21.7%). Overall, 88% of survivors resumed exercise after treatment, and 48% achieved guideline-based physical activity levels (≥ 150 min per week). The most frequently reported activities were slow walking (75.3%), housework (67.0%), and brisk walking (25.1%). The main motivators were maintaining health, improving mental well-being, and better sleep, while common barriers included time constraints, poor air quality, and fatigue. An ECOG performance status of 0 and exercising during treatment were significantly associated with post-treatment activity (adjusted odds ratios 2.73 and 3.48, respectively).

While most survivors resumed exercise after treatment, only half achieved guideline-recommended activity levels. Targeted support addressing common barriers and promoting exercise during treatment may improve long-term physical activity engagement.